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  • 1.
    Chisholm, S. A.
    et al.
    Sexually Transmitted Bacteria Reference Lab, Health Protect Agency, London, England..
    Unemo, Magnus
    Region Örebro län. Natl Reference Lab Pathogen Neisseria, Dept Lab Med, Örebro University Hospital, Örebro, Sweden.
    Quaye, N.
    Sexually Transmitted Bacteria Reference Lab, Health Protect Agency, London, England..
    Johansson, E.
    Natl Reference Lab Pathogen Neisseria, Dept Lab Med, Örebro Univ Hosp, Örebro, Sweden.
    Cole, M. J.
    Sexually Transmitted Bacteria Reference Lab, Health Protect Agency, London, England..
    Ison, C. A.
    Sexually Transmitted Bacteria Reference Lab, Health Protect Agency, London, England.
    Van de Laar, M. Jw
    European Center Disease Prevention & Control, Stockholm, Sweden.
    Molecular epidemiological typing within the European Gonococcal Antimicrobial Resistance Surveillance Programme reveals predominance of a multidrug-resistant clone2013Ingår i: Eurosurveillance, ISSN 1025-496X, E-ISSN 1560-7917, Vol. 18, nr 3, s. 14-23, artikel-id 20358Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Treatment of gonorrhoea is threatened by antimicrobial resistance, and decreased susceptibility and resistance to recommended therapies is emerging in Europe. Current associations between resistance and molecular type remain poorly understood. Gonococcal isolates (n=1,066) collected for the 2009 and 2010 European Gonococcal Antimicrobial Surveillance Programme were typed by Neisseria gonorrhoeae multi-antigen sequence typing (NG-MAST). A total of 406 sequence types (STs) were identified, 125 of which occurred in >= two isolates. Seven major genogroups of closely related STs (varying by <= 1% at just one of the two target loci) were defined. Genogroup 1407 (G1407), observed in 20/21 countries and predominant in 13/21 countries, accounted for 23% of all isolates and was associated with decreased susceptibility to cefixime and resistance to ciprofloxacin and raised minimum inhibitory concentrations for ceftriaxone and azithromycin. Genogroup 225 (G225), associated with ciprofloxacin resistance, was observed in 10% of isolates from 19/21 countries. None of the other genogroups were associated with antimicrobial resistance. The predominance of a multidrug-resistant clone (G1407) in Europe is worrying given the recent reports of recommended third generation cephalosporins failing to treat infections with this clone. Identifying associations between ST and antimicrobial resistance aids the understanding of the dissemination of resistant clones within a population and could facilitate development of targeted intervention strategies.

  • 2.
    Donachie, Alastair
    et al.
    Infectious Disease Prevention and Control Unit (IDCU) – Health Promotion and Disease Prevention Directorate, Valletta, Malta; European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.
    Spiteri, Gianfranco
    European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.
    Barbara, Christopher
    Department of Pathology, Mater Dei Hospital, Msida, Malta.
    Mellilo, Tanya
    Infectious Disease Prevention and Control Unit (IDCU) – Health Promotion and Disease Prevention Directorate, Valletta, Malta.
    Hadad, Ronza
    WHO Collaborating Centre for Gonorrhoea and Other STIs, National Reference Laboratory for STIs, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Farrugia, Alexandra Gauci
    Genitourinary Clinic, Mater Dei Hospital, Msida, Malta.
    Unemo, Magnus
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. WHO Collaborating Centre for Gonorrhoea and Other STIs, National Reference Laboratory for STIs.
    Padovese, Valeska
    Genitourinary Clinic, Mater Dei Hospital, Msida, Malta.
    Lymphogranuloma venereum (LGV) in men who have sex with men (MSM): a re-emerging problem, Malta, 20182018Ingår i: Eurosurveillance, ISSN 1025-496X, E-ISSN 1560-7917, Vol. 23, nr 43, s. 2-6, artikel-id 1800541Artikel i tidskrift (Refereegranskat)
  • 3.
    Eyre, David W.
    et al.
    Big Data Institute, University of Oxford, Oxford, United Kingdom; Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
    Sanderson, Nicholas D.
    Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
    Lord, Emily
    Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom.
    Regisford-Reimmer, Natasha
    Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom.
    Chau, Kevin
    Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
    Barker, Leanne
    Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
    Morgan, Markus
    Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom.
    Newnham, Robert
    Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom.
    Golparian, Daniel
    Örebro universitet, Institutionen för medicinska vetenskaper. WHO Collaborating Centre for Gonorrhoea and Other STIs, National Reference Laboratory for STIs, Örebro University Hospital, Örebro, Sweden.
    Unemo, Magnus
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. WHO Collaborating Centre for Gonorrhoea and Other STIs, National Reference Laboratory for STIs, Örebro University Hospital, Örebro, Sweden.
    Crook, Derrick W.
    Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom; National Infection Service, Public Health England, Colindale, United Kingdom; National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, University of Oxford, Oxford, United Kingdom .
    Peto, Tim E. A.
    Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom; National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, University of Oxford, Oxford, United Kingdom.
    Hughes, Gwenda
    National Infection Service, Public Health England, Colindale, United Kingdom.
    Cole, Michelle J.
    National Infection Service, Public Health England, Colindale, United Kingdom.
    Fifer, Helen
    National Infection Service, Public Health England, Colindale, United Kingdom.
    Edwards, Anne
    Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom.
    Andersson, Monique I.
    Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom.
    Gonorrhoea treatment failure caused by a Neisseria gonorrhoeae strain with combined ceftriaxone and high-level azithromycin resistance, England, February 20182018Ingår i: Eurosurveillance, ISSN 1025-496X, E-ISSN 1560-7917, Vol. 23, nr 27, s. 2-7, artikel-id 1800323Artikel i tidskrift (Refereegranskat)
  • 4.
    Golparian, Daniel
    et al.
    WHO Collaborating Centre for Gonorrhoea and other STIs, Swedish Reference Laboratory for Pathogenic Neisseria, Örebro University Hospital, Örebro, Sverige; Department of Laboratory Medicine, Microbiology, Örebro University Hospital, Örebro, Sweden.
    Johansson, E.
    WHO Collaborating Centre for Gonorrhoea and other STIs, Swedish Reference Laboratory for Pathogenic Neisseria, Örebro University Hospital, Örebro, Sverige; Department of Laboratory Medicine, Microbiology, Örebro University Hospital, Örebro, Sweden.
    Unemo, Magnus
    Region Örebro län. WHO Collaborating Centre for Gonorrhoea and other STIs, Swedish Reference Laboratory for Pathogenic Neisseria, Örebro University Hospital, Örebro, Sverige; Department of Laboratory Medicine, Microbiology, Örebro University Hospital, Örebro, Sweden.
    Clinical Neisseria gonorrhoeae isolate with a N. meningitidis porA gene and no prolyliminopeptidase activity, Sweden, 2011-danger of false-negative genetic and culture diagnostic results2012Ingår i: Eurosurveillance, ISSN 1025-496X, E-ISSN 1560-7917, Vol. 17, nr 9, s. 5-7, artikel-id 20102Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    We describe a Neisseria gonorrhoeae strain, found in Sweden in 2011, that harbours a N. meningitidis porA gene causing false-negative results in PCRs targeting the gonococcal porA pseudogene. Furthermore, the strain had no prolyliminopeptidase (PIP) activity that many commercial biochemical kits for species verification in culture rely on. Enhanced awareness of the spread of such strains and screening for them can be crucial.

  • 5.
    Golparian, Daniel
    et al.
    World Health Organization Collaborating Centre for Gonorrhoea and other Sexually Transmitted Infections, Swedish Reference Laboratory for Pathogenic Neisseria, Department of Laboratory Medicine, Microbiology, Örebro University Hospital, Örebro, Sweden.
    Ohlsson, A. K.
    Dept Clin Microbiol, Karolinska Univ Hosp, Stockholm, Sweden.
    Janson, H.
    Dept Clin Microbiol, Cent Hosp Växjö, Växjö, Sweden.
    Lidbrink, P.
    Dept Dermatovenereol, Karolinska Univ Hosp, Stockholm, Sweden.
    Richtner, T.
    Dept Dermatol, Karolinska Inst Södersjukhuset, Stockholm, Sweden.
    Ekelund, O.
    Dept Clin Microbiol, Cent Hosp Växjö, Växjö, Sweden.
    Fredlund, Hans
    Region Örebro län. World Health Organization Collaborating Centre for Gonorrhoea and other Sexually Transmitted Infections, Swedish Reference Laboratory for Pathogenic Neisseria, Department of Laboratory Medicine, Microbiology, Örebro University Hospital, Örebro, Sweden.
    Unemo, Magnus
    Region Örebro län. World Health Organization Collaborating Centre for Gonorrhoea and other Sexually Transmitted Infections, Swedish Reference Laboratory for Pathogenic Neisseria, Department of Laboratory Medicine, Microbiology, Örebro University Hospital, Örebro, Sweden.
    Four treatment failures of pharyngeal gonorrhoea with ceftriaxone (500 mg) or cefotaxime (500 mg), Sweden, 2013 and 20142014Ingår i: Eurosurveillance, ISSN 1025-496X, E-ISSN 1560-7917, Vol. 19, nr 30, s. 2-5, artikel-id 20862Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    We describe four cases in Sweden of verified treatment failures of pharyngeal gonorrhoea with ceftriaxone (500 mg; n=3) or cefotaxime (500 mg; n=1) monotherapy. All the ceftriaxone treatment failures were caused by the internationally spreading multidrug-resistant gonococcal NG-MAST genogroup 1407 clone. Increased awareness of treatment failures is crucial particularly when antimicrobial monotherapy is used. Frequent test of cure and appropriate verification/falsification of suspected treatment failures, as well as implementation of recommended dual antimicrobial therapy are imperative.

  • 6.
    Golparian, Daniel
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper. WHO Collaborating Centre for Gonorrhoea and other Sexually Transmitted Infections, Swedish Reference Laboratory for Sexually Transmitted Infections, Department of Laboratory Medicine, Clinical Microbiology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Rose, Lisa
    Department of Clinical Microbiology, University of Dublin, Trinity College, St. James’s Hospital, Dublin, Ireland.
    Lynam, Almida
    Guide Clinic, St. James’s Hospital, Dublin, Ireland.
    Mohamed, Aia
    Department of Clinical Microbiology, University of Dublin, Trinity College, St. James’s Hospital, Dublin, Ireland.
    Bercot, Beatrice
    APHP, St Louis Hospital, Laboratory of Microbiology; French National Reference Center for Bacterial STI, Associated laboratory for gonococci; Paris Diderot University, IAME, Sorbonne Paris Cité, Paris, France.
    Ohnishi, Makoto
    Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan.
    Crowley, Brendan
    Department of Clinical Microbiology, University of Dublin, Trinity College, St. James’s Hospital, Dublin, Ireland; National Gonococcal Reference Laboratory, St. James’s Hospital, Dublin, Ireland.
    Unemo, Magnus
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. WHO Collaborating Centre for Gonorrhoea and other Sexually Transmitted Infections, Swedish Reference Laboratory for Sexually Transmitted Infections, Department of Laboratory Medicine, Clinical Microbiology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Multidrug-resistant Neisseria gonorrhoeae isolate, belonging to the internationally spreading Japanese FC428 clone, with ceftriaxone resistance and intermediate resistance to azithromycin, Ireland, August 20182018Ingår i: Eurosurveillance, ISSN 1025-496X, E-ISSN 1560-7917, Vol. 23, nr 47, s. 6-9, artikel-id 1800617Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    We describe a multidrug-resistant Neisseria gonorrhoeae urethritis case with ceftriaxone resistance and azithromycin intermediate resistance in a heterosexual man in Ireland, August 2018. Whole-genome sequencing showed that the isolate IR72 belongs to the internationally spreading multidrug-resistant ceftriaxone-resistant FC428 clade, initially described in Japan in 2015. IR72 was assigned MSLT ST1903, NG-MAST ST17842 and NG-STAR type 1133, including the ceftriaxone resistance-mediating penA-60.001. Global awareness of spreading ceftriaxone-resistant gonococcal strains that threaten recommended dual therapies is essential.

  • 7.
    Johansen, Tone Bjordal
    et al.
    Norwegian Institute of Public Health, Oslo, Norway; European Public Health Microbiology Training Programme (EUPHEM), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.
    Kløvstad, Hilde
    Norwegian Institute of Public Health, Oslo, Norway.
    Rykkvin, Rikard
    Norwegian Institute of Public Health, Oslo, Norway.
    Herrfurth-Erichsen, Einar Bredo
    Fürst Medical Laboratory, Oslo, Norway.
    Sorthe, Joakim
    Fürst Medical Laboratory, Oslo, Norway.
    Njølstad, Gro
    Haukeland University Hospital, Bergen, Norway.
    Ebbesen, Marit Helen
    Haukeland University Hospital, Bergen, Norway.
    Nygaard, Randi Monsen
    Haukeland University Hospital, Bergen, Norway.
    Sandmoen, Ellen Kristin
    Tønsberg Hospital Trust, Department of Medical Microbiology, Tønsberg, Norway.
    Thilesen, Carina
    Unilabs Laboratory Medicine, Department of Medical Microbiology, Skien, Norway.
    Onken, Annette
    Vestre Viken Hospital Trust, Department of Microbiology, Drammen, Norway.
    Liljedal, Inger
    Levanger Hospital, Department for Laboratory Medicine, Levanger, Norway.
    Hadad, Ronza
    Örebro universitet, Institutionen för medicinska vetenskaper. WHO Collaborating Centre for Gonorrhoea and other STIs, National Reference Laboratory for STIs, Department of Laboratory Medicine.
    Unemo, Magnus
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. WHO Collaborating Centre for Gonorrhoea and other STIs, National Reference Laboratory for STIs, Department of Laboratory Medicine.
    The 'Finnish new variant of Chlamydia trachomatis' escaping detection in the Aptima Combo 2 assay is widespread across Norway, June to August 20192019Ingår i: Eurosurveillance, ISSN 1025-496X, E-ISSN 1560-7917, Vol. 24, nr 42, s. 2-6Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The 'Finnish new variant of Chlamydia trachomatis' (FI-nvCT), escaping detection in the Aptima Combo 2 assay (AC2), is widespread across Norway. From June to August 2019, 84% (81/97) of available AC2/Aptima CT discordant samples from five laboratories were confirmed as FI-nvCT. Two additional CT variants (CT 23S rRNA C1514T and G1523A) also escaped AC2 detection. The high FI-nvCT proportion might indicate a long-term national spread and it cannot be excluded that FI-nvCT emerged in Norway.

  • 8.
    Lucidarme, J.
    et al.
    Meningococcal Reference Unit, Public Health England, Manchester, United Kingdom.
    Scott, K. J.
    Scottish Haemophilus, Legionella, Meningococcus and Pneumococcus Reference Laboratory, Glasgow Royal Infirmary, Glasgow, United Kingdom.
    Ure, R.
    Scottish Haemophilus, Legionella, Meningococcus and Pneumococcus Reference Laboratory, Glasgow Royal Infirmary, Glasgow, United Kingdom.
    Smith, A.
    Scottish Haemophilus, Legionella, Meningococcus and Pneumococcus Reference Laboratory, Glasgow Royal Infirmary, Glasgow, United Kingdom; College of Medical, Veterinary & Life Sciences, Glasgow Dental Hospital & School, University of Glasgow, Glasgow, United Kingdom.
    Lindsay, D.
    Scottish Haemophilus, Legionella, Meningococcus and Pneumococcus Reference Laboratory, Glasgow Royal Infirmary, Glasgow, United Kingdom.
    Stenmark, Bianca
    Örebro universitet, Institutionen för medicinska vetenskaper. National Reference Laboratory for Pathogenic Neisseria, Department of Laboratory Medicine, Örebro University Hospital, Örebro, Sweden.
    Jacobsson, Susanne
    Örebro universitet, Institutionen för medicinska vetenskaper. National Reference Laboratory for Pathogenic Neisseria, Department of Laboratory Medicine, Örebro University Hospital, Örebro, Sweden.
    Fredlund, Hans
    Örebro universitet, Institutionen för hälsovetenskaper. National Reference Laboratory for Pathogenic Neisseria, Department of Laboratory Medicine, Örebro University Hospital, Örebro, Sweden.
    Cameron, J. C.
    Health Protection Scotland, NHS National Services Scotland, Glasgow, United Kingdom.
    Smith-Palmer, A.
    Health Protection Scotland, NHS National Services Scotland, Glasgow, United Kingdom.
    McMenamin, J.
    Health Protection Scotland, NHS National Services Scotland, Glasgow, United Kingdom.
    Gray, S. J.
    Meningococcal Reference Unit, Public Health England, Manchester, United Kingdom.
    Campbell, H.
    Immunisation Department, Public Health England, London, United Kingdom.
    Ladhani, S.
    Immunisation Department, Public Health England, London, United Kingdom.
    Findlow, J.
    Meningococcal Reference Unit, Public Health England, Manchester, United Kingdom.
    Mölling, Paula
    National Reference Laboratory for Pathogenic Neisseria, Department of Laboratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Borrow, R.
    Meningococcal Reference Unit, Public Health England, Manchester, United Kingdom.
    An international invasive meningococcal disease outbreak due to a novel and rapidly expanding serogroup W strain, Scotland and Sweden, July to August 20152016Ingår i: Eurosurveillance, ISSN 1025-496X, E-ISSN 1560-7917, Vol. 21, nr 45, s. 15-23, artikel-id 30395Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The 23rd World Scout Jamboree in 2015 took place in Japan and included over 33,000 scouts from 162 countries. Within nine days of the meeting ending, six cases of laboratory-confirmed invasive serogroup W meningococcal disease occurred among scouts and their close contacts in Scotland and Sweden. The isolates responsible were identical to one-another by routine typing and, where known (4 isolates), belonged to the ST-11 clonal complex (cc11) which is associated with large outbreaks and high case fatality rates. Recent studies have demonstrated the need for high-resolution genomic typing schemes to assign serogroup W cc11 isolates to several distinct strains circulating globally over the past two decades. Here we used such schemes to confirm that the Jamboree-associated cases constituted a genuine outbreak and that this was due to a novel and rapidly expanding strain descended from the strain that has recently expanded in South America and the United Kingdom. We also identify the genetic differences that define the novel strain including four point mutations and three putative recombination events involving the horizontal exchange of 17, six and two genes, respectively. Noteworthy outcomes of these changes were antigenic shifts and the disruption of a transcriptional regulator.

  • 9.
    Luijt, D.
    et al.
    Department of Medical Microbiology, Groningen, Netherlands.
    Di Lorenzo, C.
    Quality Control for Molecular Diagnostics, Glasgow, United Kingdom.
    van Loon, A. M.
    Quality Control for Molecular Diagnostics, Glasgow, United Kingdom.
    Unemo, Magnus
    Region Örebro län. WHO Collaborating Centre for Gonorrhoea and other STIs, Swedish Reference Laboratory for Pathogenic Neisseria, Department of Laboratory Medicine, Microbiology, Örebro University Hospital, Örebro, Sweden.
    Most but not all laboratories can detect the recently emerged Neisseria gonorrhoeae porA mutants - results from the QCMD 2013 N. gonorrhoeae external quality assessment programme2014Ingår i: Eurosurveillance, ISSN 1025-496X, E-ISSN 1560-7917, Vol. 19, nr 8, s. 2-5, artikel-id 20711Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    We describe the results of the Quality Control for Molecular Diagnostics 2013 Neisseria gonorrhoeae external quality assessment programme that included an N. gonorrhoeae strain harbouring an N. meningitidis porA gene which causes false-negative results in molecular diagnostic assays targeting the gonococcal porA pseudogene. Enhanced awareness of the international transmission of such gonococcal strains is needed to avoid false-negative results in both in-house and commercial molecular diagnostic assays used in laboratories worldwide, but particularly in Europe.

    In recent years, false-negative test results using PCRs targeting the Neisseria gonorrhoeae porA pseudogene have been reported from Australia, Scotland, Sweden and England [1-4]. Further investigations revealed that the gonococcal strains were not clonal, but all had replaced large segments or their entire N. gonorrhoeae porA pseudogene with an N. meningitidis porA gene.

    This report describes the results of the Quality Control for Molecular Diagnostics (QCMD) 2013 N. gonorrhoeae External Quality Assessment (EQA) programme. It included an N. gonorrhoeae strain containing an N. meningitidis porA gene which gives rise to false-negative results in molecular diagnostic assays targeting the gonococcal porA pseudogene. QCMD (www.qcmd.org) is an independent international organisation which provides a wide range of molecular EQA services in the field of infectious diseases to over 2,000 participants in over 100 countries.

  • 10.
    Poncin, Thibault
    et al.
    Infectious Agents Department, Saint Louis Hospital, APHP, Paris, France; French National Reference Center for bacterial STI, Associated laboratory for gonococci, APHP, Paris, France.
    Fouere, Sebastien
    Dermatology Department, CeGGID (Free Information Screening and Diagnostics Centers), Saint Louis Hospital, APHP, Paris, France.
    Braille, Aymeric
    Infectious Agents Department, Saint Louis Hospital, APHP, Paris, France; French National Reference Center for bacterial STI, Associated laboratory for gonococci, APHP, Paris, France.
    Camelena, Francois
    Infectious Agents Department, Saint Louis Hospital, Assistance Publique – Hôpitaux de Paris (APHP), Paris, France; French National Reference Center for bacterial STI, Associated laboratory for gonococci, APHP, Paris, France; IAME, UMR 1137 Université Paris Diderot, Paris, France.
    Agsous, Myriem
    Infectious Agents Department, Saint Louis Hospital, APHP, Paris, France; French National Reference Center for bacterial STI, Associated laboratory for gonococci, APHP, Paris, France.
    Bebear, Cecile
    USC EA 3671 Mycoplasmal and chlamydial infections in humans, University of Bordeaux, Bordeaux, France; French National Reference Center for bacterial STIs, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France.
    Kumanski, Sylvain
    French National Reference Center for bacterial STI, Associated laboratory for gonococci, APHP, Paris, France.
    Lot, Florence
    Santé Publique France, French National Public Health Agency, Saint-Maurice, France.
    Mercier-Delarue, Severine
    Infectious Agents Department, Saint Louis Hospital, APHP, Paris, France.
    Ngangro, Ndeindo Ndeikoundam
    Santé Publique France, French National Public Health Agency, Saint-Maurice, France.
    Salmona, Maud
    Infectious Agents Department, Saint Louis Hospital, APHP, Paris, France.
    Schnepf, Nathalie
    Infectious Agents Department, Saint Louis Hospital, APHP, Paris, France; French National Reference Center for bacterial STI, Associated laboratory for gonococci, APHP, Paris, France.
    Timsit, Julie
    Dermatology Department, CeGGID (Free Information Screening and Diagnostics Centers), Saint Louis Hospital, APHP, Paris, France.
    Unemo, Magnus
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. WHO Collaborating Centre for Gonorrhoea and Other STIs, National Reference Laboratory for STIs.
    Bercot, Beatrice
    Infectious Agents Department, Saint Louis Hospital, APHP, Paris, France; French National Reference Center for bacterial STI, Associated laboratory for gonococci, APHP, Paris, France.
    Multidrug-resistant Neisseria gonorrhoeae failing treatment with ceftriaxone and doxycycline in France, November 20172018Ingår i: Eurosurveillance, ISSN 1025-496X, E-ISSN 1560-7917, Vol. 23, nr 21, s. 1-3, artikel-id 1800264Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    We report a multidrug-resistant Neisseria gonorrhoeae urogenital and pharyngeal infection with ceftriaxone resistance and intermediate resistance to azithromycin in a heterosexual woman in her 205 in France. Treatment with ceftriaxone plus doxycycline failed for the pharyngeal localisation. Whole-genome sequencing of isolate F-90 identified MIST1903 , NG-MAST ST343, NG-STAR(233) , and relevant resistance determinants. F-90 showed phenotypic and genotypic similarities to an internationally spreading multidrug-resistant and ceftriaxone-resistant clone detected in Japan and subsequently in Australia, Canada and Denmark.

  • 11.
    Smith-Palmer, A.
    et al.
    Health Protection Scotland, Glasgow, United Kingdom.
    Oates, K.
    NHS Highland, Inverness, United Kingdom.
    Webster, D.
    NHS Grampian, Aberdeen, United Kingdom.
    Taylor, S.
    NHS Shetland, Lerwick, United Kingdom.
    Scott, K. J.
    Scottish Haemophilus, Legionella, Meningococcus and Pneumococcus Reference Laboratory, Glasgow, United Kingdom.
    Smith, G.
    International Health Regulations National Focal Point, Public Health England, London, United Kingdom.
    Parcell, B.
    NHS Grampian, Aberdeen, United Kingdom.
    Lindstrand, A.
    Public Health Agency of Sweden, Solna, Sweden.
    Wallensten, A.
    Public Health Agency of Sweden, Solna, Sweden.
    Fredlund, Hans
    Örebro universitet, Institutionen för hälsovetenskaper. National Reference Laboratory for Pathogenic Neisseria, Örebro University Hospital, Örebro, Sweden.
    Widerström, M.
    Stockholm County Council Medical Officer, Stockholm, Sweden.
    McMenamin, J.
    Health Protection Scotland, Glasgow, United Kingdom.
    Outbreak of Neisseria meningitidis capsular group W among scouts returning from the World Scout Jamboree, Japan, 20152016Ingår i: Eurosurveillance, ISSN 1025-496X, E-ISSN 1560-7917, Vol. 21, nr 45, s. 8-14, artikel-id 30392Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The 23rd World Scout Jamboree was held in Japan from 28 July to 8 August 2015 and was attended by over 33,000 scouts from 162 countries. An outbreak of invasive meningococcal disease capsular group W was investigated among participants, with four confirmed cases identified in Scotland, who were all associated with one particular scout unit, and two confirmed cases in Sweden; molecular testing showed the same strain to be responsible for illness in both countries. The report describes the public health action taken to prevent further cases and the different decisions reached with respect to how wide to extend the offer of chemoprophylaxis in the two countries; in Scotland, chemoprophylaxis was offered to the unit of 40 participants to which the four cases belonged and to other close contacts of cases, while in Sweden chemoprophylaxis was offered to all those returning from the Jamboree. The report also describes the international collaboration and communication required to investigate and manage such multinational outbreaks in a timely manner.

  • 12.
    Törös, B.
    et al.
    National Reference Laboratory for Pathogenic Neisseria, Department of Laboratory Medicine, Clinical Microbiology/Molecular diagnostics R&D, Örebro University Hospital, Örebro, Sweden.
    Thulin [Hedberg], Sara
    Region Örebro län. National Reference Laboratory for Pathogenic Neisseria, Department of Laboratory Medicine, Clinical Microbiology/Molecular diagnostics R&D, Örebro University Hospital, Örebro, Sweden.
    Jacobsson, Susanne
    Region Örebro län. National Reference Laboratory for Pathogenic Neisseria, Department of Laboratory Medicine, Clinical Microbiology/Molecular diagnostics R&D, Örebro University Hospital, Örebro, Sweden.
    Fredlund, Hans
    Region Örebro län. National Reference Laboratory for Pathogenic Neisseria, Department of Laboratory Medicine, Clinical Microbiology/Molecular diagnostics R&D, Örebro University Hospital, Örebro, Sweden.
    Olcén, P.
    National Reference Laboratory for Pathogenic Neisseria, Department of Laboratory Medicine, Clinical Microbiology/Molecular diagnostics R&D, Örebro University Hospital, Örebro, Sweden.
    Mölling, Paula
    Region Örebro län. National Reference Laboratory for Pathogenic Neisseria, Department of Laboratory Medicine, Clinical Microbiology/Molecular diagnostics R&D, Örebro University Hospital, Örebro, Sweden.
    Surveillance of invasive Neisseria meningitidis with a serogroup Y update, Sweden 2010 to 20122014Ingår i: Eurosurveillance, ISSN 1025-496X, E-ISSN 1560-7917, Vol. 19, nr 42, s. 25-33, artikel-id UNSP 20940Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    An increase of invasive meningococcal disease caused by Neisseria meningitidis serogroup Y has been noted in Sweden since 2005, and to a lower extent throughout Europe. The present study describes the epidemiology of invasive N. meningitidis isolates in Sweden in the period between 2010 and 2012, with a focus on serogroup Y. We also aimed to find an optimal molecular typing scheme for both surveillance and outbreak investigations. All invasive N. meningitidis isolates in Sweden during the study period (n=208) were genetically characterised. Serogroup Y predominated with 22/57, 31/61 and 44/90 of all invasive isolates (incidence 0.23, 0.33 and 0.46 per 100,000 population) in 2010, 2011 and 2012 respectively. In each of these years, 15/22, 22/31 and 19/44 of serogroup Y isolates were genetically clonal (Y: P1.5-2,10-1,36-2: F4-1: ST-23(cc23), 'porB allele 3-36, fHbp allele 25 and penA allele 22). Our findings further support those of others that currently recommended FetA typing could be replaced by FHbp. Moreover, in line with a previous study that we conducted, the current results indicate that highly variable multilocus variable-number tandem repeat analysis (HV-MLVA) can be used as a first-hand rapid method for small outbreak investigations.

  • 13.
    Unemo, Magnus
    Department of Laboratory Medicine, Microbiology, Örebro University Hospital, Örebro, Sweden.
    The '2012 European guideline on the diagnosis and treatment of gonorrhoea in adults' recommends dual antimicrobial therapy2012Ingår i: Eurosurveillance, ISSN 1025-496X, E-ISSN 1560-7917, Vol. 17, nr 47, s. 27-27, artikel-id 20323Artikel i tidskrift (Refereegranskat)
  • 14.
    Unemo, Magnus
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. WHO Collaborating Centre for Gonorrhoea and other STIs, National Reference Laboratory for STIs, Department of Laboratory Medicine.
    Getman, Damon
    Hologic Inc., San Diego CA, United States.
    Hadad, Ronza
    WHO Collaborating Centre for Gonorrhoea and other STIs, National Reference Laboratory for STIs, Department of Laboratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Cole, Michelle
    National Infection Service, Public Health England, London, United Kingdom.
    Thomson, Nicholas
    Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, United Kingdom.
    Puolakkainen, Mirja
    Department of Virology and Immunology, University of Helsinki and Helsinki University Hospital, Huslab, Helsinki, Finland.
    Spiteri, Gianfranco
    European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.
    Letter to the editor: Chlamydia trachomatis samples testing falsely negative in the Aptima Combo 2 test in Finland, 20192019Ingår i: Eurosurveillance, ISSN 1025-496X, E-ISSN 1560-7917, Vol. 24, nr 24, s. 20-21, artikel-id 1900354Artikel i tidskrift (Refereegranskat)
  • 15.
    Unemo, Magnus
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. World Health Organization Collaborating Centre for Gonorrhoea and Other Sexually Transmitted Infections (STIs), National Reference Laboratory for STIs, Department of Laboratory Medicine.
    Hansen, Marit
    World Health Organization Collaborating Centre for Gonorrhoea and Other Sexually Transmitted Infections (STIs), National Reference Laboratory for STIs, Department of Laboratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Hadad, Ronza
    World Health Organization Collaborating Centre for Gonorrhoea and Other Sexually Transmitted Infections (STIs), National Reference Laboratory for STIs, Department of Laboratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Lindroth, Ylva
    Department of Laboratory Medicine, Medical Microbiology, Lund University, Skåne Laboratory Medicine, Lund, Sweden.
    Fredlund, Hans
    World Health Organization Collaborating Centre for Gonorrhoea and Other Sexually Transmitted Infections (STIs), National Reference Laboratory for STIs, Department of Laboratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Puolakkainen, Mirja
    Department of Virology and Immunology, University of Helsinki and Helsinki University Hospital, HUSLAB, Helsinki, Finland.
    Sundqvist, Martin
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. World Health Organization Collaborating Centre for Gonorrhoea and Other Sexually Transmitted Infections (STIs), National Reference Laboratory for STIs, Department of Laboratory Medicine.
    Finnish new variant of Chlamydia trachomatis escaping detection in the Aptima Combo 2 assay also present in Orebro County, Sweden, May 20192019Ingår i: Eurosurveillance, ISSN 1025-496X, E-ISSN 1560-7917, Vol. 24, nr 26, s. 10-14, artikel-id 1900370Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    We identified the first two cases of the Finnish new variant of Chlamydia trachomatis (F-nvCT) beyond Finland in two clinical urogenital specimens in Orebro County, Sweden. These Aptima Combo 2 assay-negative specimens were Aptima Chlamydia trachomatis (CT) assay positive and had the characteristic C1515T mutation in the 23S rRNA gene. From 22 March to 31 May 2019, 1.3% (2/158) of the CT-positive cases in Orebro County were missed because of the F-nvCT. International awareness, investigations and actions are essential.

  • 16.
    Unemo, Magnus
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin. WHO Collaborating Centre for Gonorrhoea and other Sexually Transmitted Infections, Department of Laboratory Medicine, Microbiology, Örebro University Hospital, Örebro, Sweden.
    Lanjouw, E.
    Department of Dermatology, Erasmus Medical Center, Rotterdam, the Netherlands.
    European STI Guidelines Editorial Board, Group author
    The '2015 European guideline on the management of Chlamydia trachomatis infections' has now been published2015Ingår i: Eurosurveillance, ISSN 1025-496X, E-ISSN 1560-7917, Vol. 20, nr 48, s. 28-29, artikel-id 30080Artikel i tidskrift (Övrig (populärvetenskap, debatt, mm))
  • 17.
    Wallensten, A.
    et al.
    Public Health Agency of Sweden, Solna, Sweden; Department of Medical Sciences, Infectious Diseases, Uppsala University, Uppsala, Sweden.
    Fredlund, Hans
    Region Örebro län. Department of Laboratory Medicine Clinical Microbiology, Communicable Disease Control Unit, Örebro University Hospital, Örebro, Sweden.
    Runehagen, A.
    Communicable Diseases Control Unit, Kronoberg County Council, Växjö, Sweden.
    Multiple human-to-human transmission from a severe case of psittacosis, Sweden, January-February 20132014Ingår i: Eurosurveillance, ISSN 1025-496X, E-ISSN 1560-7917, Vol. 19, nr 42, s. 34-39, artikel-id 20937Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Proven transmission of Chlamydia psittaci between humans has been described on only one occasion previously. We describe an outbreak which occurred in Sweden in early 2013, where the epidemiological and serological investigation suggests that one patient, severely ill with psittacosis after exposure to wild bird droppings, transmitted the disease to ten others: Two family members, one hospital roommate and seven hospital caregivers. Three cases also provided respiratory samples that could be analysed by PCR. All the obtained C. psittaci sequences were indistinguishable and clustered within genotype A. The finding has implications for the management of severely ill patients with atypical pneumonia, because these patients may be more contagious than was previously thought. In order to prevent nosocomial person-to-person transmission of C. psittaci, stricter hygiene measures may need to be applied.

  • 18.
    Weinbaum, Barbara
    et al.
    Research and Development, Hologic Inc., San Diego, United States.
    Williams, Analee
    Research and Development, Hologic Inc., San Diego, United States.
    Hadad, Ronza
    Örebro universitet, Institutionen för medicinska vetenskaper. World Health Organization Collaborating Centre for Gonorrhoea and Other Sexually Transmitted Infections (STIs), National Reference Laboratory for STIs, Department of Laboratory Medicine.
    Vinluan, Bryan
    Research and Development, Hologic Inc., San Diego, United States.
    Puolakkainen, Mirja
    Department of Virology and Immunology, University of Helsinki and Helsinki University Hospital, HUSLAB, Helsinki, Finland.
    Unemo, Magnus
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. World Health Organization Collaborating Centre for Gonorrhoea and Other Sexually Transmitted Infections (STIs), National Reference Laboratory for STIs, Department of Laboratory Medicine.
    Getman, Damon
    Research and Development, Hologic Inc., San Diego, United States.
    Validation of an Aptima-format Finnish new variant of Chlamydia trachomatis (FI-nvCT) surveillance assay, 20192020Ingår i: Eurosurveillance, ISSN 1025-496X, E-ISSN 1560-7917, Vol. 25, nr 5, s. 16-22, artikel-id 2000038Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The Finnish new variant of Chlamydia trachomatis (FI-nvCT) is escaping diagnostics in Finland, Norway and Sweden. We have developed and validated an Aptima-format nucleic acid amplification test (NAAT) designed specifically to detect the FI-nvCT. This NAAT has high sensitivity (100%) and specificity (100%) for the FI-nvCT strain, enabling further investigation of the geographic distribution, prevalence and transmission of this diagnostic-escape mutant in screening populations in Europe.

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