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Jacobsson, Susanne
Publications (10 of 37) Show all publications
Ingberg, E., Mölling, P., Jacobsson, S., Alm, E., Hedin, K. & Sundqvist, M. (2018). 16S metagenomics for bacterial identification versus cultures in acute pharyngotonsillitis patients and controls. In: : . Paper presented at 28th European Congress of Clinical Microbiology and Infectious Diseases, Madrid, Spain, 21-24 April, 2018.
Open this publication in new window or tab >>16S metagenomics for bacterial identification versus cultures in acute pharyngotonsillitis patients and controls
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2018 (English)Conference paper, Poster (with or without abstract) (Refereed)
Abstract [en]

Background: Sore throat/pharyngotonsillitis is a very common condition. While most cases are viral, the primary bacterial pathogen is group A beta-hemolytic streptococcus (Streptococcus pyogenes). Further, Fusobacterium necrophorum has over the last decade attracted attention. rnrnSequence-based techniques continue to gain ground in medical microbiology. To describe the microbiota in a sample, either the whole genomes (metagenomics) or marker genes/genomic regions (metataxonomics), such as the 16S rRNA gene, can be sequenced. Some studies have investigated how findings from these methods correspond to conventional microbiological methods for infectious diseases, such as cultures. However, no previous study has approached the condition acute pharyngotonsillitis this way.

Methods: Throat samples from patients with acute sore throat (n=129) and controls (n=86), both groups aged 15-45, were collected. DNA was extracted and the V3-V4 regions of the 16S rRNA genes were amplified using PCR. After normalization based on fragment analysis, and size selection with Ampure beads and PCR against adapter sequences coupled to the V3-V4 fragments, clonal amplifiction was performed with isothermal PCR. Finally, sequencing was performed on the Ion Torrent S5 XL. The SILVA database was used for taxonomic classification and the results were compared to culture findings for S. pyogenes and F. necrophorum, using Mann Whitney U tests.

Results: Among the 215 samples, 46 patients and 1 of the controls were culture-positive for S. pyogenes. For F. necrophorum, 20 patients and 3 controls were culture-positive. Seven of the samples were culture-positive for both S. pyogenes and F. necrophorum. rnrnIn the metataxonomic analysis, S. pyogenes were significantly more abundant among patients than controls (p=0.0046), and in samples culture-positive for S. pyogenes, compared to culture-negative (p<0.0001).

The percent of reads representing F. necrophorum were significantly higher in patients compared to controls (p<0.001), as well as in culture-positive samples compared to culture-negative (p<0.0001). rnrnAlthough significant differences between culture-positive and culture-negative samples were seen, even among culture-positive samples the abundance of S. pyogenes or F. necrophorum were on average low (2,1% and 10,6%, respectively) and with large variation (0-49,8% and 0-76,1%, respectively).

Conclusions: Findings from a metataxonomic 16S rRNA gene analysis differed regarding species of interest between groups based on symptoms of a sore throat or culture findings. However, the results were heterogeneous and difficult to interpret for a single sample.

National Category
Infectious Medicine
Identifiers
urn:nbn:se:oru:diva-67260 (URN)
Conference
28th European Congress of Clinical Microbiology and Infectious Diseases, Madrid, Spain, 21-24 April, 2018
Available from: 2018-06-14 Created: 2018-06-14 Last updated: 2018-06-14Bibliographically approved
Jönsson, A., Foerster, S., Golparian, D., Hamasuna, R., Jacobsson, S., Lindberg, M., . . . Unemo, M. (2018). In vitro activity and time-kill curve analysis of sitafloxacin against a global panel of antimicrobial-resistant and multidrug-resistant Neisseria gonorrhoeae isolates. Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS), 126(1), 29-37
Open this publication in new window or tab >>In vitro activity and time-kill curve analysis of sitafloxacin against a global panel of antimicrobial-resistant and multidrug-resistant Neisseria gonorrhoeae isolates
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2018 (English)In: Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS), ISSN 0903-4641, E-ISSN 1600-0463, Vol. 126, no 1, p. 29-37Article in journal (Refereed) Published
Abstract [en]

Treatment of gonorrhoea is a challenge worldwide because of emergence of resistance in N. gonorrhoeae to all therapeutic antimicrobials available and novel antimicrobials are imperative. The newer-generation fluoroquinolone sitafloxacin, mostly used for respiratory tract infections in Japan, can have a high in vitro activity against gonococci. However, only a limited number of recent antimicrobial-resistant isolates from Japan have been examined. We investigated the sitafloxacin activity against a global gonococcal panel (250 isolates cultured in 1991-2013), including multidrug-resistant geographically, temporally and genetically diverse isolates, and performed time-kill curve analysis for sitafloxacin. The susceptibility to sitafloxacin (agar dilution) and seven additional therapeutic antimicrobials (Etest) was determined. Sitafloxacin was rapidly bactericidal, and the MIC range, MIC50 and MIC90 was ≤0.001-1, 0.125 and 0.25 mg/L, respectively. There was a high correlation between the MICs of sitafloxacin and ciprofloxacin; however, the MIC50 and MIC90 of sitafloxacin were 6-fold and >6-fold lower, respectively. Sitafloxacin might be an option for particularly dual antimicrobial therapy of gonorrhoea and for cases with ceftriaxone resistance or allergy. However, further in vitro and particularly in vivo evaluations of potential resistance, pharmacokinetics/pharmacodynamics and ideal dosing for gonorrhoea, as well as performance of randomized controlled clinical, trials are crucial.

Place, publisher, year, edition, pages
Wiley-Blackwell Publishing Inc., 2018
Keywords
Gonorrhoea, bactericidal, fluoroquinolone, gyrA, in vitro potency, quinolone resistance-determining region, time-kill curve analysis
National Category
Infectious Medicine Immunology in the medical area
Identifiers
urn:nbn:se:oru:diva-64051 (URN)10.1111/apm.12777 (DOI)000418846700005 ()29154480 (PubMedID)2-s2.0-85034566762 (Scopus ID)
Note

Funding Agencies:

Örebro County Council Research Committee 

Foundation for Medical Research at Örebro University Hospital, Sweden 

Available from: 2018-01-12 Created: 2018-01-12 Last updated: 2018-08-31Bibliographically approved
Jacobsson, S., Golparian, D., Scangarella-Oman, N. & Unemo, M. (2018). In vitro activity of the novel triazaacenaphthylene gepotidacin (GSK2140944) against MDR Neisseria gonorrhoeae. Journal of Antimicrobial Chemotherapy, 73(8), 2072-2077
Open this publication in new window or tab >>In vitro activity of the novel triazaacenaphthylene gepotidacin (GSK2140944) against MDR Neisseria gonorrhoeae
2018 (English)In: Journal of Antimicrobial Chemotherapy, ISSN 0305-7453, E-ISSN 1460-2091, Vol. 73, no 8, p. 2072-2077Article in journal (Refereed) Published
Abstract [en]

Objectives: Increased antimicrobial resistance surveillance and new effective antimicrobials are crucial to maintain treatable gonorrhoea. We examined the in vitro activity of gepotidacin, a novel triazaacenaphthylene, and the effect of efflux pump inactivation on clinical Neisseria gonorrhoeae isolates and international reference strains (n = 252) and compared gepotidacin with antimicrobials currently or previously recommended for gonorrhoea treatment.

Methods: MICs (mg/L) were determined by agar dilution (gepotidacin) or by Etest (seven other antimicrobials). The gyrA and parC genes were sequenced and the impact of inactivation of the MtrCDE, MacAB and NorM efflux pumps on gepotidacin MICs was examined.

Results: Gepotidacin showed potent in vitro activity against all gonococcal isolates (n = 252; MIC <= 4 mg/L). The modal MIC, MIC50 , MIC90 and MIC range of gepotidacin were 0.5, 0.5, 1 and 0.032-4 mg/L, respectively. Inactivation of the MtrCDE efflux pump, but not MacAB or NorM, decreased the gepotidacin MICs for most strains. No significant cross-resistance between gepotidacin and any other antimicrobials, including the fluoroquinolone ciprofloxacin, was identified. However, the ParC D86N mutation (possibly together with additional antimicrobial resistance mutation), which is associated with fluoroquinolone resistance, was associated with increased gepotidacin MICs.

Conclusions: Gepotidacin demonstrated high in vitro activity against gonococcal strains, indicating that gepotidacin could potentially be an effective option for gonorrhoea treatment, particularly in a dual antimicrobialtherapy regimen and for patients with resistance or allergy to extended-spectrum cephalosporins. Nevertheless, elucidating in vitro and in vivo resistance emergence and mechanisms in detail, together with further gonorrhoea clinical studies, ideally also including chlamydia and Mycoplasma genitalium are essential.

Place, publisher, year, edition, pages
Oxford University Press, 2018
National Category
Infectious Medicine Microbiology in the medical area Pharmacology and Toxicology
Identifiers
urn:nbn:se:oru:diva-68651 (URN)10.1093/jac/dky162 (DOI)000440948600009 ()29796611 (PubMedID)
Note

Funding Agencies:

Örebro County Council Research Committee, Örebro, Sweden  

Foundation for Medical Research at Örebro University Hospital, Örebro, Sweden  

GlaxoSmithKline, Collegeville, PA, USA through federal funds from the Office of the Assistant Secretary for Preparedness and Response, Biomedical Advanced Research and Development Authority  HHSO100201300011C 

Available from: 2018-08-31 Created: 2018-08-31 Last updated: 2018-08-31Bibliographically approved
Jacobsson, S., Stenmark, B., Hedberg, S. T., Mölling, P. & Fredlund, H. (2018). Neisseria meningitidis carriage in Swedish teenagers associated with the serogroup W outbreak at the World Scout Jamboree, Japan 2015. Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS), 126(4), 337-341
Open this publication in new window or tab >>Neisseria meningitidis carriage in Swedish teenagers associated with the serogroup W outbreak at the World Scout Jamboree, Japan 2015
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2018 (English)In: Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS), ISSN 0903-4641, E-ISSN 1600-0463, Vol. 126, no 4, p. 337-341Article in journal (Refereed) Published
Abstract [en]

The aims of the study were to estimate the carrier state of Neisseria meningitidis in Swedish teenagers and its association with an outbreak at the World Scout Jamboree in 2015 as well as to compare sensitivity of throat versus nasopharyngeal swab for optimal detection of carriage. In total, 1 705 samples (cultures n = 32, throat swabs n = 715, nasopharyngeal swabs n = 958) from 1 020 Jamboree participants were collected and sent to the National Reference Laboratory for Neisseria meningitidis for culture and molecular analysis. The overall positivity for N. meningitidis was 8% (83/1 020), whereas 2% (n = 22) belonged to a known sero/genogroup while the majority (n = 61) were non-groupable. Throat sample is clearly the sampling method of choice, in 56 individuals where both throat and nasopharynx samples were taken, N. meningitidis was detected in both throat and nasopharynx in eight individuals, in 46 individuals N. meningitidis was only detected in the throat and in two individuals only in the nasopharynx. Carriage studies are important to provide knowledge of the current epidemiology and association between carrier isolates and disease-causing isolates in a given population. Therefore, planning for a carriage study in Sweden is in progress.

Place, publisher, year, edition, pages
Wiley-Blackwell Publishing Inc., 2018
Keywords
Neisseria meningitidis; serogroup W; World Scout Jamboree; carriage
National Category
Occupational Health and Environmental Health Immunology in the medical area Microbiology in the medical area
Identifiers
urn:nbn:se:oru:diva-65835 (URN)10.1111/apm.12819 (DOI)000428351400009 ()29543345 (PubMedID)2-s2.0-85044426003 (Scopus ID)
Note

Funding Agencies:

Örebro County Council Research Committee  

Foundation for Medical Research at Örebro University Hospital, Sweden  

Available from: 2018-03-16 Created: 2018-03-16 Last updated: 2018-08-20Bibliographically approved
Jönsson, A., Jacobsson, S., Foerster, S., Cole, M. J. & Unemo, M. (2018). Performance characteristics of newer MIC gradient strip tests compared with the Etest for antimicrobial susceptibility testing of Neisseria gonorrhoeae. Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS), 126(10), 822-827
Open this publication in new window or tab >>Performance characteristics of newer MIC gradient strip tests compared with the Etest for antimicrobial susceptibility testing of Neisseria gonorrhoeae
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2018 (English)In: Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS), ISSN 0903-4641, E-ISSN 1600-0463, Vol. 126, no 10, p. 822-827Article in journal (Refereed) Published
Abstract [en]

For Neisseria gonorrhoeae susceptibility testing, Etest, comparable to agar dilution, is frequently used. In recent years, newer MIC gradient strip tests have been commercialized. However, these tests have not been appropriately evaluated for gonococci. We evaluated the sensitivity, specificity, accuracy, quality, availability of antimicrobials and cost of the MIC Test Strip (Liofilchem), M.I.C.Evaluator (Oxoid) and Ezy MIC Strip (HiMedia), compared to the reference Etest (bioMérieux), for gonococcal susceptibility testing. The MICs of eight antimicrobials in 103 gonococcal international reference strains (n = 29) and clinical isolates (n = 74) were examined. Coefficient of determination (R2), complete agreement, essential agreement, SIR categorical agreement, sensitivity, specificity and accuracy were calculated. R2 of the MICs for the antimicrobials ranged between 0.674–0.996, 0.617–0.993, and 0.643–0.994 for the MIC Test Strip, M.I.C.Evaluator strips and Ezy MIC Strips respectively. The essential agreement (SIR categorical agreement) was 99.6% (88.6%), 100% (87.1%) and 93.0% (83.1%) respectively. M.I.C.Evaluator strips for gonococcal key antimicrobials were lacking and the Ezy MIC Strips showed an inconsistent accuracy, quality and some strips were contaminated. The Liofilchem MIC Test Strips had limitations, but might be relatively accurate alternatives to Etest for gonococci. Strict quality assurance (at manufacturing and testing laboratory), including quality controls, are required.

Place, publisher, year, edition, pages
Wiley-Blackwell Publishing Inc., 2018
Keywords
Etest, Ezy MIC Strips (HiMedia), M.I.C.Evaluator (Oxoid), MIC Test Strip (Liofilchem), MIC gradient strip test, gonorrhoea
National Category
Dermatology and Venereal Diseases Microbiology in the medical area Biomedical Laboratory Science/Technology
Identifiers
urn:nbn:se:oru:diva-68800 (URN)10.1111/apm.12887 (DOI)000445849800005 ()30191618 (PubMedID)2-s2.0-85052951947 (Scopus ID)
Note

Funding Agencies:

Örebro County Council Research Committee  

Foundation for Medical Research at Örebro University Hospital, Sweden  

Available from: 2018-09-10 Created: 2018-09-10 Last updated: 2018-10-16Bibliographically approved
Harris, S. R., Cole, M. J., Spiteri, G., Sanchez-Buso, L., Golparian, D., Jacobsson, S., . . . Unemo, M. (2018). Public health surveillance of multidrug-resistant clones of Neisseria gonorrhoeae in Europe: a genomic survey. Lancet. Infectious diseases (Print), 18(7), 758-768
Open this publication in new window or tab >>Public health surveillance of multidrug-resistant clones of Neisseria gonorrhoeae in Europe: a genomic survey
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2018 (English)In: Lancet. Infectious diseases (Print), ISSN 1473-3099, E-ISSN 1474-4457, Vol. 18, no 7, p. 758-768Article in journal (Refereed) Published
Abstract [en]

Background: Traditional methods for molecular epidemiology of Neisseria gonorrhoeae are suboptimal. Whole-genome sequencing (WGS) offers ideal resolution to describe population dynamics and to predict and infer transmission of antimicrobial resistance, and can enhance infection control through linkage with epidemiological data. We used WGS, in conjunction with linked epidemiological and phenotypic data, to describe the gonococcal population in 20 European countries. We aimed to detail changes in phenotypic antimicrobial resistance levels (and the reasons for these changes) and strain distribution (with a focus on antimicrobial resistance strains in risk groups), and to predict antimicrobial resistance from WGS data.

Methods: We carried out an observational study, in which we sequenced isolates taken from patients with gonorrhoea from the European Gonococcal Antimicrobial Surveillance Programme in 20 countries from September to November, 2013. We also developed a web platform that we used for automated antimicrobial resistance prediction, molecular typing (N gonorrhoeae multi-antigen sequence typing [NG-MAST] and multilocus sequence typing), and phylogenetic clustering in conjunction with epidemiological and phenotypic data.

Findings: The multidrug-resistant NG-MAST genogroup G1407 was predominant and accounted for the most cephalosporin resistance, but the prevalence of this genogroup decreased from 248 (23%) of 1066 isolates in a previous study from 2009-10 to 174 (17%) of 1054 isolates in this survey in 2013. This genogroup previously showed an association with men who have sex with men, but changed to an association with heterosexual people (odds ratio=4.29). WGS provided substantially improved resolution and accuracy over NG-MAST and multilocus sequence typing, predicted antimicrobial resistance relatively well, and identified discrepant isolates, mixed infections or contaminants, and multidrug-resistant clades linked to risk groups.

Interpretation: To our knowledge, we provide the first use of joint analysis of WGS and epidemiological data in an international programme for regional surveillance of sexually transmitted infections. WGS provided enhanced understanding of the distribution of antimicrobial resistance clones, including replacement with clones that were more susceptible to antimicrobials, in several risk groups nationally and regionally. We provide a framework for genomic surveillance of gonococci through standardised sampling, use of WGS, and a shared information architecture for interpretation and dissemination by use of open access software.

Place, publisher, year, edition, pages
Elsevier, 2018
National Category
Infectious Medicine
Identifiers
urn:nbn:se:oru:diva-68145 (URN)10.1016/S1473-3099(18)30225-1 (DOI)000436794600036 ()29776807 (PubMedID)2-s2.0-85047186207 (Scopus ID)
Note

Funding Agencies:

European Centre for Disease Prevention and Control  

Centre for Genomic Pathogen Surveillance  

Örebro University Hospital  

Wellcome 

Available from: 2018-07-26 Created: 2018-07-26 Last updated: 2018-09-04Bibliographically approved
Day, M. J., Spiteri, G., Jacobsson, S., Woodford, N., Amato-Gauci, A. J., Cole, M. J., . . . Euro-GASP, n. (2018). Stably high azithromycin resistance and decreasing ceftriaxone susceptibility in Neisseria gonorrhoeae in 25 European countries, 2016. BMC Infectious Diseases, 18(1), Article ID 609.
Open this publication in new window or tab >>Stably high azithromycin resistance and decreasing ceftriaxone susceptibility in Neisseria gonorrhoeae in 25 European countries, 2016
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2018 (English)In: BMC Infectious Diseases, ISSN 1471-2334, E-ISSN 1471-2334, Vol. 18, no 1, article id 609Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The European Gonococcal Antimicrobial Surveillance Programme (Euro-GASP) performs annual sentinel surveillance of Neisseria gonorrhoeae susceptibility to therapeutically relevant antimicrobials across the European Union/European Economic Area (EU/EEA). We present the Euro-GASP results from 2016 (25 countries), linked to patient epidemiological data, and compared with data from previous years.

METHODS: Agar dilution and minimum inhibitory concentration (MIC) gradient strip methodologies were used to determine the antimicrobial susceptibility (using EUCAST breakpoints) of 2660 N. gonorrhoeae isolates from 25 countries across the EU/EEA. Significance of differences compared with Euro-GASP results in previous years was analysed using Z-tests.

RESULTS: No isolates with resistance to ceftriaxone (MIC > 0.125 mg/L) were detected in 2016 (one in 2015). However, the proportion of isolates with decreased susceptibility to ceftriaxone (MICs from 0.03 mg/L to 0.125 mg/L) increased significantly (p = 0.01) from 2015 to 2016. There were 14 (0.5%) isolates with ceftriaxone MICs 0.125 mg/L (on the resistance breakpoint), of which one isolate was resistant to azithromycin and four showed intermediate susceptibility to azithromycin. Cefixime resistance was detected in 2.1% of isolates in 2016 compared with 1.7% in 2015 (p = 0.26) and azithromycin resistance in 7.5% in 2016 compared with 7.1% in 2015 (p = 0.74). Seven (0.3%) isolates from five countries displayed high-level azithromycin resistance (MIC≥256 mg/L) in 2016 compared with five (0.2%) isolates in 2015. Resistance rate to ciprofloxacin was 46.5% compared with 49.4% in 2015 (p = 0.06). No isolates were resistant to spectinomycin and the MICs of gentamicin remained stable compared with previous years.

CONCLUSIONS: Overall AMR rates in gonococci in EU/EEA remained stable from 2015 to 2016. However, the ceftriaxone MIC distribution shifted away from the most susceptible (≤0.016 mg/L) and the proportion of isolates with decreased susceptibility to ceftriaxone increased significantly. This development is of concern as current European gonorrhoea management guideline recommends ceftriaxone 500 mg plus azithromycin 2 g as first-line therapy. With azithromycin resistance at 7.5%, the increasing ceftriaxone MICs might soon threaten the effectiveness of this therapeutic regimen and requires close monitoring.

Place, publisher, year, edition, pages
BioMed Central, 2018
Keywords
Antimicrobial resistance, Azithromycin, Ceftriaxone, Europe, European Economic Area (EEA), European Union (EU), European gonococcal antimicrobial surveillance Programme (Euro-GASP), Gonorrhoea, Surveillance, Treatment
National Category
Biochemistry and Molecular Biology Infectious Medicine
Identifiers
urn:nbn:se:oru:diva-70516 (URN)10.1186/s12879-018-3528-4 (DOI)30509194 (PubMedID)2-s2.0-85057607331 (Scopus ID)
Available from: 2018-12-05 Created: 2018-12-05 Last updated: 2018-12-17Bibliographically approved
Jacobsson, S., Boiko, I., Golparian, D., Blondeel, K., Kiarie, J., Toskin, I., . . . Unemo, M. (2018). WHO laboratory validation of Xpert((R)) CT/NG and Xpert((R)) TV on the GeneXpert system verifies high performances. Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS), 126(12), 907-912
Open this publication in new window or tab >>WHO laboratory validation of Xpert((R)) CT/NG and Xpert((R)) TV on the GeneXpert system verifies high performances
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2018 (English)In: Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS), ISSN 0903-4641, E-ISSN 1600-0463, Vol. 126, no 12, p. 907-912Article in journal (Refereed) Published
Abstract [en]

Effective tests for diagnosis of sexually transmitted infections (STIs), used point of care to inform treatment and management decisions, are urgently needed. We evaluated the analytical sensitivity and specificity of the Xpert((R)) CT/NG and Xpert((R)) TV tests, examining 339 samples spiked with phenotypically and/or genetically diverse strains of Neisseria gonorrhoeae, Chlamydia trachomatis, and Trichomonas vaginalis, and other related species that may cross-react. The APTIMA Combo 2 test and APTIMA TV test were used as reference tests. The analytical sensitivity for all three agents in the Xpert((R)) CT/NG and Xpert((R)) TV tests was <= 10(2) genome equivalents/reaction. The analytical specificity of both tests was high. False-positive results were identified in the Xpert((R)) TV test when challenging with high concentrations of Trichomonas tenax, Trichomonas gallinae, Trichomonas stableri, and Trichomonas aotus. However, the clinical relevance of these cross-reactions can likely be neglected, because these species have not been identified in urogenital samples from humans. In conclusion, the analytical sensitivity and specificity of the user-friendly Xpert((R)) CT/NG and Xpert((R)) TV tests on the GeneXpert system were high. The results support the use of specimens from also extra-genital sites, for example, pharynx and rectum. However, appropriate clinical validations are additionally required.

Place, publisher, year, edition, pages
John Wiley & Sons, 2018
Keywords
GeneXpert, Xpert((R)) CT/NG, Xpert((R)) TV, point of care, Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis
National Category
Immunology in the medical area Microbiology in the medical area
Identifiers
urn:nbn:se:oru:diva-70362 (URN)10.1111/apm.12902 (DOI)000450513700004 ()30456870 (PubMedID)2-s2.0-85056739969 (Scopus ID)
Note

Funding Agencies:

Department of Reproductive Health and Research, World Health Organization (WHO), Geneva, Switzerland  

Örebro County Council Research Committee, Örebro, Sweden  

Foundation for Medical Research at Örebro University Hospital, Örebro, Sweden  

Available from: 2018-11-29 Created: 2018-11-29 Last updated: 2018-11-29Bibliographically approved
Eriksson, L., Hedberg, S. T., Jacobsson, S., Fredlund, H., Mölling, P. & Stenmark, B. (2018). Whole-Genome Sequencing of Emerging Invasive Neisseria meningitidis Serogroup W in Sweden. Journal of Clinical Microbiology, 56(4), Article ID e01409-17.
Open this publication in new window or tab >>Whole-Genome Sequencing of Emerging Invasive Neisseria meningitidis Serogroup W in Sweden
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2018 (English)In: Journal of Clinical Microbiology, ISSN 0095-1137, E-ISSN 1098-660X, Vol. 56, no 4, article id e01409-17Article in journal (Refereed) Published
Abstract [en]

Invasive disease caused by Neisseria meningitidis serogroup W (MenW) has historically had a low incidence in Sweden, with an average incidence of 0.03 case/100,000 population from 1995 to 2014. In recent years, a significant increase in the incidence of MenW has been noted in Sweden, to an average incidence of 0.15 case/100,000 population in 2015 to 2016. In 2017 (1 January to 30 June), 33% of invasive meningococcal disease cases (7/21 cases) were caused by MenW. In the present study, all invasive MenW isolates from Sweden collected in 1995 to June 2017 (n = 86) were subjected to whole-genome sequencing to determine the population structure and to compare isolates from Sweden with historical and international cases. The increase of MenW in Sweden was determined to be due to isolates belonging to the South American sublineage of MenW clonal complex 11, namely, the novel U.K. 2013 lineage. This lineage was introduced in Sweden in 2013 and has since been the dominant lineage of MenW.

Place, publisher, year, edition, pages
American Society for Microbiology, 2018
Keywords
CC11, Neisseria meningitidis, invasive meningococcal disease, serogroup W, whole-genome sequencing
National Category
Infectious Medicine
Identifiers
urn:nbn:se:oru:diva-66477 (URN)10.1128/JCM.01409-17 (DOI)000429718700010 ()29321195 (PubMedID)2-s2.0-85044717735 (Scopus ID)
Note

Funding Agencies:

Örebro County Council Research Committee

Nyckelfonden

Wellcome Trust

European Union

Available from: 2018-04-13 Created: 2018-04-13 Last updated: 2018-09-05Bibliographically approved
Säll, O., Stenmark, B., Glimåker, M., Jacobsson, S., Mölling, P., Olcén, P. O. & Fredlund, H. (2017). Clinical presentation of invasive disease caused by Neisseria meningitidis serogroup Y in Sweden, 1995 to 2012. Epidemiology and Infection, 145(10), 2137-2143
Open this publication in new window or tab >>Clinical presentation of invasive disease caused by Neisseria meningitidis serogroup Y in Sweden, 1995 to 2012
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2017 (English)In: Epidemiology and Infection, ISSN 0950-2688, E-ISSN 1469-4409, Vol. 145, no 10, p. 2137-2143Article in journal (Refereed) Published
Abstract [en]

Over the period 1995-2012, the incidence of invasive meningococcal disease (IMD) caused by Neisseria meningitidis serogroup Y (NmY) increased significantly in Sweden. This is mainly due to the emergence of a predominant cluster named strain type YI subtype 1, belonging to the ST-23 clonal complex (cc). The aim of this study was to examine the clinical picture of patients with invasive disease caused by NmY and to analyse whether the predominant cluster exhibits certain clinical characteristics that might explain the increased incidence. In this retrospective observational study, the medical records available from patients with IMD caused by Nm serogroup Y in Sweden between 1995 and 2012 were systematically reviewed. Patient characteristics, in-hospital findings and outcome were studied and differences between the dominating cluster and other isolates were analysed. Medical records from 175 of 191 patients were retrieved. The median age was 62 years. The all-cause mortality within 30 days of admission was 9% (15/175) in the whole material; 4% (2/54) in the cohort with strain type YI subtype 1 and 11% (12/121) among patients with other isolates. Thirty-three per cent of the patients were diagnosed with meningitis, 19% with pneumonia, 10% with arthritis and 35% were found to have bacteraemia but no apparent organ manifestation. This survey included cases with an aggressive clinical course as well as cases with a relatively mild clinical presentation. There was a trend towards lower mortality and less-severe disease in the cohort with strain type YI subtype 1 compared with the group with other isolates.

Place, publisher, year, edition, pages
Cambridge University Press, 2017
Keywords
Invasive meningococcal disease, meningococcal disease, Neisseria meningitidis, Neisseria meningitidis serogroup Y, Sweden
National Category
Infectious Medicine Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:oru:diva-58934 (URN)10.1017/S0950268817000929 (DOI)000404243900018 ()28478773 (PubMedID)2-s2.0-85018441510 (Scopus ID)
Note

Funding Agency:

Region Örebro County Research Committee 

Available from: 2017-08-21 Created: 2017-08-21 Last updated: 2018-08-01Bibliographically approved
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