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  • 1.
    Athlin, Simon
    et al.
    Region Örebro län.
    Strålin, Kristoffer
    Örebro University Hospital, Örebro, Sweden; Karolinska University Hospital, Stockholm, Sweden.
    The Binax NOW Streptococcus pneumoniae test applied on nasopharyngeal aspirates to support pneumococcal aetiology in community-acquired pneumonia.2013Ingår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 45, nr 6, s. 425-31Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: The use of nasopharyngeal secretions to enhance diagnostic yields of pneumococcal aetiology in community-acquired pneumonia (CAP) is of interest. We evaluated the Binax NOW Streptococcus pneumoniae immunochromatographic test (ICT) on nasopharyngeal aspirates (NPA) in order to support pneumococcal aetiology in CAP.

    METHODS: The NPA ICT was applied on 180 adult CAP patients and 64 healthy controls. The rate of pneumococcal detection in the nasopharynx was compared to rates for lytA polymerase chain reaction (PCR) and culture on NPA.

    RESULTS: According to blood and sputum culture and urine ICT, the test sensitivity in 59 patients with a pneumococcal aetiology was 81%. The specificity was suboptimal, with 72% negative tests among CAP patients without a pneumococcal aetiology. However, the test was positive in only 11% of patients with atypical pneumonia and in 4.7% of healthy controls. The positivity rate was higher for NPA ICT compared to culture on NPA in all CAP patients, and to both PCR and culture on NPA in non-pneumococcal non-atypical CAP patients. In 113 (63%) patients with β-lactam monotherapy, cure without treatment alteration was noted more often in cases with positive compared to negative NPA ICT at admission (91% vs 69%; p < 0.01).

    CONCLUSIONS: The high sensitivity and the low positivity rates in patients with atypical pneumonia and healthy controls, in combination with the correlation between positive test results and clinical cure with β-lactam therapy, may support a pneumococcal aetiology in CAP in populations with low pneumococcal carriage rates.

  • 2.
    Eliasson, Henrik
    et al.
    Örebro universitet, Hälsoakademin.
    Bäck, Erik
    Örebro universitet, Hälsoakademin.
    Tularaemia in an emergent area in Sweden: An analysis of 234 cases in five years2007Ingår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 39, nr 10, s. 880-889Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    A retrospective study of clinical tularaemia in an emergent area in Sweden is presented. 234 patients seen during the y 2000-2004 were studied, using case files and a questionnaire. There was a predominance of ulceroglandular tularaemia (89%), occurring in late summer and early autumn, reflecting the dominance of mosquito-borne transmission. The incubation period varied from a few hours to 11 d, with a median of 3 d. Cutaneous manifestations of tularaemia, apart from primary lesions, were noted in 43% of the cases. Coughing was common, even in patients with ulceroglandular tularaemia, supporting the view that haematogenous spread to the respiratory system occurs. Regular laboratory tests, such as WBC, ESR and C-reactive protein, were in general only moderately elevated. In the earlier y studied, the Doctor's Delay was substantial as was the misdiagnosis and prescription of inadequate antibiotics. In the later y, however, the delay and misdiagnosis were significantly lower, reflecting the increased recognition of the disease by the physicians in the area. A few relapses occurred, all in patients treated with doxycycline. No lethality was seen, reflecting the benign course of tularaemia type B infection.

  • 3.
    Eliasson, Henrik
    et al.
    Örebro universitet, Hälsoakademin.
    Sjöstedt, Anders
    Bäck, Erik
    Clinical use of a diagnostic PCR for Francisella tularensis in patients with suspected ulceroglandular tularaemia2005Ingår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 37, nr 11, s. 833-837Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    A retrospective analysis to evaluate the clinical use of a diagnostic PCR for Francisella tularensis in patients with suspected ulceroglandular tularaemia was performed. 154 samples, 129 from patients with definitive tularaemia and 25 from patients where tularaemia could be ruled out, were analysed. The diagnostic PCR had a specificity of 96%, a sensitivity of 78.3%, and a Positive Predictive Value of 99%. Especially samples from encrusted lesions, even up to 4 weeks old, in patients with tularaemia, were PCR positive to a high degree when taken properly. The diagnostic PCR is useful in suspected ulceroglandular tularaemia, giving a fast and accurate diagnosis.

  • 4.
    Hedberg, Sara Thulin
    et al.
    Örebro universitet, Hälsoakademin.
    Olcén, Per
    Fredlund, Hans
    Örebro universitet, Hälsoakademin.
    Unemo, Magnus
    Örebro universitet, Hälsoakademin.
    Antibiotic susceptibility of invasive Neisseria meningitidis isolates from 1995 to 2008 in Sweden: the meningococcal population remains susceptible2010Ingår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 42, nr 1, s. 61-64Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The susceptibility to 7 antibiotics was determined for all Swedish invasive Neisseria meningitidis isolates from 1995 to 2008 (N=717). In general, these remain highly susceptible to the antibiotics recommended for use. Accordingly, penicillin G remains effective for the treatment of invasive meningococcal disease and ciprofloxacin appropriate for prophylaxis.

  • 5.
    Höök, Helena
    et al.
    Division of Food Hygiene and Bacteriology, Department of Biomedical Sciences and Veterinary Public Health, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, Uppsala.
    Ekegren, Maj-Britt
    Department of Infectious Diseases Control, County Hospital, Västerås.
    Ericsson, Henrik
    Division of Food Hygiene and Bacteriology, Department of Biomedical Sciences and Veterinary Public Health, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, Uppsala.
    Vågsholm, Ivar
    Swedish Zoonosis Center, National Veterinary Institute, Uppsala.
    Danielsson-Tham, Marie-Louise
    Division of Food Hygiene and Bacteriology, Department of Biomedical Sciences and Veterinary Public Health, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, Uppsala.
    Genetic and epidemiological relationships among Campylobacter isolates from humans2004Ingår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 36, s. 435-442Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    84 Campylobacter jejuni isolates from Swedish patients with domestic infection were characterized with pulsed-field gel electrophoresis (PFGE), and the subtype information considered in relation to epidemiological data. Based on pattern combinations from restriction cleavage with SmaI and SalI, 52 different PFGE types were identified. Types with an average pattern similarity of at least 82% and 63% were assembled in groups and clusters, respectively. The 2 largest clusters included 71% of the isolates. The distribution in time varied between different groups and clusters, where some were isolated sporadically during the whole period and others appeared more concentrated in time. Types in 1 cluster were significantly more often isolated in summer than other types in the study. Isolates from children showed lower pattern similarity to other isolates than isolates from adults. Sets of type and time related cases, possibly representing small outbreaks, were identified when indistinguishable PFGE patterns were found in isolates from temporally related cases. Our results indicate that although a large number of genotypes may be found among C. jejuni strains infecting humans, a large proportion of these may be genetically related, and that different genotypes may appear during different seasons and infect individuals of different ages.

  • 6. Jacobsson, Susanne
    et al.
    Olcén, Per
    Löfdahl, Margareta
    Fredlund, Hans
    Örebro universitet, Hälsoakademin.
    Mölling, Paula
    Characteristics of Neisseria meningitidis isolates causing fatal disease2008Ingår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 40, nr 9, s. 734-744Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The objectives of the present study were to describe a selection of characteristics of all available fatal meningococcal isolates (n=62) and to compare these with all the other invasive isolates (non-fatal, n=474) collected in Sweden from 1995 to 2004 (fatality rate of 12%). The coverage of the fatal isolates by presently discussed outer membrane vesicle (OMV) vaccines was also estimated. The isolates were characterized by serogroup, serotype, genosubtype, multilocus sequence type and antibiogram. Basic epidemiological data were gathered. The results of the fatal isolates showed 55% serogroup B, 27% C, 15% Y and 3% W-135, with a fatality rate of 11% for B, 12% for C, 17% for Y and 8% for W-135. Characteristics associated with higher mortality were age, gender, serogroup Y, serotype 14 and 15 and genosubtypes P1.7,16-29,35 and P1.5-1,10-4,36-2. In contrast, non-14/non-15 serotypes, the genosubtypes P1.5-1,10-8,36-2; P1.7-2,4,37 and P1.7,16,35, as well as reduced sensitivity for penicillin G were associated with decreased mortality. The presently discussed OMV vaccines could, based solely on the complete genosubtype, theoretically cover up to 44% of the fatal serogroup B cases and up to 100% if every variable region by itself is capable to induce protective immunity.

  • 7.
    Jakobsson, Hedvig
    et al.
    Department of Bacteriology, Swedish Institute for Infectious Disease Control, Stockholm; Departments of Microbiology, Tumuor and Cell Biology, Karolinska Institute, Stockholm.
    Wreiber, Karin
    Department of Bacteriology, Swedish Institute for Infectious Disease Control, Stockholm.
    Fall, Katja
    Department of Medical Epidemiology, Karolinska Institute, Stockholm.
    Fjelstad, Björn
    Mora County Hospital, Mora.
    Nyrén, Olof
    Department of Medical Epidemiology, Karolinska Institute, Stockholm.
    Engstrand, Lars
    Department of Bacteriology, Swedish Institute for Infectious Disease Control, Stockholm.
    Macrolide resistance in the normal microbiota after Helicobacter pylori treatment2007Ingår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 39, nr 9, s. 757-63Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Large-scale chemoprevention of peptic ulcer disease and gastric cancer through eradication of Helicobacter pylori would expose large population groups to antibiotics, which raises concerns about possible dissemination of antibiotic resistance. The objective of this cohort study was to determine whether a triple therapy, containing omeprazole, clarithromycin, and metronidazole, of H. pylori infection increases the prevalence of macrolide resistance in the normal microbiota. 85 patients with a peptic ulcer disease with verified H. pylori infection and 12 dyspeptic patients without positive findings upon endoscopy were included. Minimal inhibitory concentrations of clarithromycin for Staphylococcus, Streptococcus, Enterococcus and Bacteroides spp. were determined from samples taken before and after treatment, and 1 y later. Before treatment, macrolide resistance was observed in 11%, 31%, 9% and 11% of the staphylococci, streptococci, enterococci and Bacteroides, respectively. The number of resistant isolates remained elevated after 1 y, most notably for staphylococci and streptococci. No development of persistent resistance was detected in the untreated control group. Triple therapy including clarithromycin leads to persistent macrolide resistance in the normal microbiota. A prevalent pool of resistance genes in the normal microbiota constitutes an ecological hazard that needs to be considered before global treatment programmes for eradication of H. pylori are implemented.

  • 8.
    Jendeberg, Anna Lange
    et al.
    Dept Infect Dis, Örebro University Hospital, Örebro, Sweden.
    Stralin, Kristoffer
    Dept Infect Dis, Örebro University Hosp, Örebro, Sweden; Dept Infect Dis, Karolinska University Hospital, Stockholm, Sweden.
    Hultgren, Olof
    Region Örebro län. Dept Clin Immunol & Microbiol.
    Antimicrobial peptide plasma concentrations in patients with community-acquired pneumonia2013Ingår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 45, nr 6, s. 432-437Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Community-acquired pneumonia (CAP) is a common and potentially life-threatening infection. Innate immunity is the first line of defence, and antimicrobial peptides (AMPs) produced by white blood cells and at epithelial barriers participate by killing microorganisms and neutralizing bacterial toxins. We wanted to investigate whether concentrations of AMPs (1) are increased in CAP, (2) predict the clinical outcome, and (3) differ depending on the causative microbe. Methods: Plasma concentrations of AMPs were measured using an enzyme-linked immunosorbent assay in 89 patients with CAP, 21 patients with non-respiratory tract infections (non-RTI), and 63 healthy control subjects. Results: In subjects with CAP, mean plasma concentrations of secretory leukocyte protease inhibitor (SLPI) and bactericidal/permeability-increasing protein (BPI) were significantly higher than in healthy control subjects (85 vs 45 ng/ml, p < 0.001 and 48 vs 10 ng/ml, p < 0.001, respectively), but less markedly increased in patients with non-RTI (68 ng/ml, p = 0.06 and 41 ng/ml, p = 0.43). LL-37 and human neutrophil peptides 1-3 (HNP 1-3) levels were not increased in subjects with CAP. Levels of BPI and SLPI did not correlate to severity of disease, and AMP levels did not differ depending on the causative agent. Interestingly, male subjects with CAP displayed increased concentrations of SLPI compared to females. This was not observed in subjects with non-RTI and healthy control subjects. Conclusions: Subjects with CAP showed increased plasma concentrations of SLPI and BPI compared to healthy control subjects. The finding of higher SLPI levels in male subjects with CAP implies that there are sex-dependent immunological differences in SLPI turnover.

  • 9. Kucinskiene, Vesta
    et al.
    Juseviciute, Violeta
    Valiukeviciene, Skaidra
    Milasauskiene, Zemyna
    Unemo, Magnus
    Örebro universitet, Hälsoakademin.
    Domeika, Marius
    Home sampling and pooling of vaginal samples are effective tools for genetic screening of Chlamydia trachomatis among high school female students in Lithuania2008Ingår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 40, nr 2, s. 88-93Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aims were 1) to estimate the prevalence of C. trachomatis infection among sexually active female students in Kaunas, Lithuania; 2) to investigate the usefulness of personal invitation, self-sampling, and pooling of samples for screening; and 3) to evaluate the costs of the approaches used. A cross-sectional study inviting 795 female students (18–31 y of age) from 7 high schools and 1 college in Kaunas was performed. The response rate was 67% (533/795). Self-obtained vaginal samples were analysed, individually and pooled (n=3), using Digene Hybrid Capture II CT/NG Test. The overall prevalence of C. trachomatis infection was 5.6%. Among the sexually active female students 20–24 y of age (n=424), the prevalence was 7.1%; however, the prevalence varied from 0% to 14.2% at the different schools. For estimation of the population prevalence based solely on identification of C. trachomatis positive pools, the pooling strategy reduced the costs by 85%. For estimation of population prevalence and for diagnosis of each individual sample, pooling reduced the costs by 70%. Targeted screening, using pooling to reduce the expenses, mainly of 3rd and 4th y Lithuanian female students could be recommended. By extended personal contact and internet-based communication, increased participation rates may be attained.

  • 10. Lagerström, Folke
    et al.
    Engfeldt, Peter
    Örebro universitet, Institutionen för klinisk medicin.
    Holmberg, Hans
    C-reactive protein in diagnosis of community-acquired pneumonia in adult patients in primary care2006Ingår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 38, nr 11-12, s. 964-969Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The usefulness of non-specific inflammatory parameters for the diagnosis of community- acquired pneumonia (CAP) in primary care is not settled. The aim of this study was to assess the value of serum C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and white blood cell count (WBC) for this purpose. These inflammatory parameters, as well as the aetiological agents, were studied in 82 patients with radiologically confirmed CAP. CRP was elevated (>5 mg/l) in 76 patients, with a median value of 65 mg/l. 25 patients had a value of over 100 mg/l. In 32 patients the CRP levels were <50 mg/l and in 17 patients they were <20 mg/l. ESR varied from 5 to 100 mm/h, with a median value of 53 mm/h; in 21 patients the value was <30 mm/h. WBC varied from 4.4 to 21.4x10(9)/l, with a median value of 9.8x10(9)/l. No associations between the levels of the inflammatory parameters and the various aetiologies were found. It is concluded that the examined inflammatory parameters did not contribute notably in the routine diagnosis of CAP established by clinical measures.

  • 11.
    Lagging, Martin
    et al.
    Dept Infect Dis, Inst Biomed, Univ Gothenburg, Gothenburg, Sweden.
    Duberg, Ann-Sofi
    Dept Infect Dis, Örebro Univ Hosp, Örebro, Sweden.
    Wejstål, Rune
    Dept Infect Dis, Inst Biomed, Univ Gothenburg, Gothenburg, Sweden; Swedish Reference Grp Antiviral Therapy RAV, Karolinska Univ Hosp, Stockholm, Sweden.
    Weiland, Ola
    Dept Infect Dis, Karolinska Univ Hosp, Stockholm, Sweden.
    Lindh, Magnus
    Dept Infect Dis, Inst Biomed, Univ Gothenburg, Gothenburg, Sweden.
    Aleman, Soo
    Dept Infect Dis, Karolinska Univ Hosp, Stockholm, Sweden.
    Josephson, Filip
    Medical Products Agency (Läkemedelsverket), Uppsala, Sweden.
    Treatment of hepatitis C virus infection in adults and children: updated Swedish consensus recommendations2012Ingår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 44, nr 7, s. 502-521Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Swedish recommendations for the treatment of hepatitis C virus (HCV) infection were updated at a recent expert meeting. Therapy for acute HCV infection should be initiated if spontaneous resolution does not occur within 12 weeks. The recommended standard-of-care therapy for chronic HCV genotype 1 infection is an HCV protease inhibitor in combination with peginterferon (peg-IFN) and ribavirin. Treatment is strongly recommended in patients with bridging fibrosis and cirrhosis, whereas in patients with less advanced fibrosis, deferring therapy may be preferential in light of likely therapeutic improvements in the near future. Patients with chronic genotype 2/3 infection should generally be treated with peg-IFN and ribavirin for 24 weeks. In patients with a very rapid viral response (i.e. HCV RNA below 1000 IU/ml on day 7), or favourable baseline characteristics and undetectable HCV RNA week 4, treatment can be shortened to 12-16 weeks, provided that no dose reductions are needed.

  • 12.
    Lagging, Martin
    et al.
    Sahlgrens Univ Hosp, Dept Infect Dis & Virol, Gothenburg, Sweden.
    Wejstål, Rune
    Sahlgrens Univ Hosp, Dept Infect Dis & Virol, Gothenburg, Sweden; Swedish Reference Grp Antiviral Therapy RAV, Uppsala, Sweden.
    Uhnoo, Ingrid
    Med Prod Agcy, Uppsala, Sweden.
    Gerdén, Barbro
    Med Prod Agcy, Uppsala, Sweden.
    Fischler, Björn
    Karolinska Univ Hosp, Dept Paediat, Stockholm, Sweden.
    Friman, Styrbjörn
    Sahlgrens Univ Hosp, Dept Transplantat & Liver Surg, Gothenburg, Sweden.
    Josephson, Filip
    Karolinska Univ Hosp, Dept Clin Pharmacol, Stockholm, Sweden.
    Karlström, Olle
    Karolinska Univ Hosp, Dept Infect Dis, Stockholm, Sweden.
    Sangfelt, Per
    Univ Uppsala Hosp, Dept Infect Dis & Gastroenterol, Uppsala, Sweden.
    Schvarz, Robert
    Karolinska Univ Hosp, Dept Infect Dis, Stockholm, Sweden.
    Weiland, Ola
    Karolinska Univ Hosp, Dept Infect Dis, Stockholm, Sweden.
    Treatment of hepatitis C virus infection: updated Swedish Consensus recommendations2009Ingår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 41, nr 6-7, s. 389-402Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    In a recent expert meeting, Swedish recommendations for the treatment of HCV infection were upgraded. The panel recommends vaccination against both hepatitis A and B in patients with HCV. Therapy for symptomatic acute HCV infection should be initiated if spontaneous resolution has not occurred within 12 weeks, whereas asymptomatic acute HCV should be treated upon detection. Patients with genotype 2/3 infection should generally be treated for 24 weeks. In patients with a very rapid viral response (vRVR), i.e. HCV RNA below 1000 IU/ml on d 7, treatment can be shortened to 12-16 weeks, provided that no dose reduction has been made. For genotype 1 patients with rapid viral response (RVR), 24 weeks treatment is recommended. For patients with a complete early viral response (cEVR), 48 weeks treatment is recommended, whereas 72 weeks treatment should be considered for patients with partial early viral response (pEVR). For patients with difficult-to-treat disease and with pronounced anaemia, erythropoietin can be used to maintain the ribavirin dose. In HCV-HIV coinfected patients, combination therapy for HCV should, if possible, be initiated before anti-retroviral therapy (ART) is indicated. For liver transplant patients pre-emptive therapy is not recommended; hence, treatment should be deferred until histological recurrence.

  • 13. Lindh, Magnus
    et al.
    Uhnoo, Ingrid
    Bläckberg, Joans
    Duberg, Ann-Sofi
    Örebro universitet, Hälsoakademin.
    Friman, Stybjörn
    Fischler, Björn
    Karlström, Olof
    Norkrans, Gunnar
    Reichard, Olle
    Sangfeldt, Per
    Söderström, Ann
    Sönnerborg, Anders
    Weiland, Ola
    Wejstål, Rune
    Wiström, Johan
    Treatment of chronic hepatitis B infection: an update of Swedish recommendations2008Ingår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 40, nr 6-7, s. 436-450Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The main goal for treatment of chronic hepatitis B is to prevent complications such as liver cirrhosis or hepatocellular carcinoma. Knowledge from population studies of the long-term risk of chronic HBV infection, as well as the recent introduction of pegylated interferon and additional nucleoside analogues has changed the therapeutic situation. Recently, a Swedish expert panel convened to update the national recommendations for treatment. The panel recommends treatment for patients with active HBV infection causing protracted liver inflammation or significant liver fibrosis, verified by liver histology. In general, pegylated interferon alpha-2a is recommended as first-line treatment, in particular for HBeAg-positive patients with HBV genotypes A or B. Among nucleoside analogues, entecavir is the first choice and adefovir or tenofovir can be used as alternatives. Lamivudine monotherapy is not recommended due to the high risk of resistance development. Combinations of nucleoside analogues such as tenofovir and lamivudine or emtricitabine are alternatives for patients with non-response or infection with resistant variants, or as first choice for patients with advanced liver disease. Nucleoside analogue treatment should be monitored to detect primary non-response and virological breakthrough. Special recommendations are given for HBV/HIV coinfected patients, immunosuppressed patients, children, and for treatment before and after liver transplantation. The present guideline is translated from Swedish, where it is published on the MPA and RAV websites (www.mpa.se and www.rav.nu.se) including 7 separate papers based on thorough literature search. The complete reference list can be received from the Medical Products Agency upon request.

  • 14.
    Malm, Kerstin
    et al.
    Örebro University Hospital, Örebro, Sweden.
    Ekermo, Bengt
    Linköping University Hospital, Linköping, Sweden.
    Hillgren, Kristina
    Maria Beroendecentrum, Centre for Dependency Disorders, Stockholm, Sweden.
    Britton, Sven
    Karolinska University Hospital, Solna, Sweden.
    Fredlund, Hans
    Örebro University Hospital, Örebro, Sweden.
    Andersson, Sören
    Örebro University Hospital, Örebro, Sweden.
    Prevalence of human T-lymphotropic virus type 1 and 2 infection in Sweden2012Ingår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 44, nr 11, s. 852-9Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Prevalence data on human T-lymphotropic virus types 1 and 2 (HTLV-1/2) in Sweden have not been updated since 1995. The seroprevalence among blood donors at that time was 0.2/10,000. A few years earlier, a high prevalence of HTLV-2 was found in intravenous drug users (IDUs) in Stockholm (3.4%). The objective of this study was to update information on the seroprevalence of HTLV in several study groups.

    METHODS: Serum samples from pregnant women, hepatitis C virus (HCV)-positive individuals, and IDUs in Stockholm were investigated for HTLV-1/2 antibodies. Data from the mandatory HTLV-1/2 screening (2003-2006) of in vitro fertilization (IVF) clients were compiled, as well as data from new blood donors.

    RESULTS: Eight out of 35,000 IVF patients were positive for anti-HTLV-1/2 (seroprevalence 2.3 per 10,000). Of the anti-HCV-positive individuals (n = 355), 1 sample was HTLV-1-positive (28.2 per 10,000). From 1995 to 2007, 18 HTLV-positive new blood donors were identified out of approximately 550,000 individuals tested (0.3 per 10,000). Thirty-five of 1079 tested IDUs were screening reactive.

    CONCLUSIONS: Since the start of screening in 1994, there has been no increased seroprevalence of HTLV-1/2 among blood donors in Sweden. Seroprevalence among Swedish IVF patients is 10 times higher than among blood donors. This finding is comparable to a 2003 European seroprevalence study of pregnant women in 7 countries. However, the possibility that the IVF group includes individuals with a higher risk of acquiring sexually transmitted infections, including HTLV, than the general population cannot be ruled out.

  • 15.
    Norda, Rut
    et al.
    Departments of Transfusion Medicine and Immunohemotherapy, Örebro Medical Center Hospital, Örebro, Sweden.
    Duberg, Ann-Sofi
    Departments of Infectious Diseases, Örebro Medical Center Hospital, Örebro, Sweden.
    Sönnerborg, Anders
    Departments of Clinical Microbiology and Immunology, Örebro Medical Center Hospital, Örebro, Sweden.
    Olcén, Per
    Departments of Division of Clinical Virology, Karolinska Institutet, Huddinge University Hospital, Huddinge, Sweden.
    Transmission of hepatitis C virus by transfusion in Orebro County, Sweden, 1990-19921995Ingår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 27, nr 5, s. 449-452Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    A retrospective study of hepatitis C virus (HCV) transmission by transfusion was conducted in Orebro county. Out of the 7,900 active, registered blood donors, 21 repeatedly anti-HCV reactive (RIVA 2 positive or indeterminate) donors were diagnosed. Their 84 recipients from January 1990 through June 1992 were identified and 41 (49%) were alive in December 1992. A total of 13 anti-HCV reactive (RIBA 2 positive or indeterminate) were diagnosed in 39 investigated recipients. Of these 11 were previously undiagnosed, and seven were HCV RNA-positive. In the donor population 1.03% were anti-HCV-positive by ELISA, but only 0.09% were RIBA and HCV RNA-positive. In 1990, 0.06% of the blood components came from the HCV RNA-positive donors, and none during the first 6 months of 1992. In order to identify transfusion-transmitted HCV infections that took place before the introduction of tests for anti-HCV antibodies, patients with a history of transfusion and symptoms and signs of liver dysfunction or damage should be thoroughly tested.

  • 16.
    Risberg, Stefan
    et al.
    Örebro universitet, Hälsoakademin.
    Engfeldt, Peter
    Örebro universitet, Hälsoakademin.
    Hugosson, Svante
    Örebro universitet, Hälsoakademin.
    Incidence of peritonsillar abscess and relationship to age and gender: Retrospective study2008Ingår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 40, nr 10, s. 792-796Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The incidence of peritonsillitis is not very well known. A retrospective study was performed at the Ear, Nose and Throat clinic (ENT) at the University Hospital of Örebro Sweden. We studied every case from 2002 to 2004 and related it to a well-defined catchment area of 179,200 inhabitants. We identified 283 events of peritonsillitis, of which 85 were defined as peritonsillar cellulitis (PTC). Peritonsillar abscess (PTA) was found in 198 events in patients between 7 and 82 y of age. 13 patients had 2 episodes of PTA during the study period. The overall incidence was 37/100,000/y. The highest incidence was found between 14 and 21 y of age, with 124/100,000/y. The male: female ratio was 1: 1. Affected females were younger than males (p=0.04), and the peak incidence was earlier for females. This may be due to differences in immunological response, owing to hormonal maturation. The annual incidence of PTA was higher in this study than found in previous studies, which is probably attributable to the fact that our study identified almost all cases in the population.

  • 17.
    Risberg, Stefan
    et al.
    Örebro universitet, Hälsoakademin.
    Engfeldt, Peter
    Örebro universitet, Hälsoakademin.
    Hugosson, Svante
    Örebro University Hospital, Örebro, Sweden.
    Peritonsillar abscess and cellulitis and their relation to a positive antigen detection test for streptococcal infection2010Ingår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 42, nr 10, s. 747-751Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The microbiological cause of peritonsillar abscess and the role of group A beta-haemolytic Streptococcus (GAS) are unclear. We performed a retrospective study at the ear, nose and throat clinic (ENT) of Orebro University Hospital, Sweden, and included 376 events of peritonsillitis between 2002 and 2004. We determined if the patients had visited a primary healthcare centre (PHCC) within 30 days prior to inclusion. The results of the rapid antigen detection test for GAS (Strep A) taken at the PHCC were compared with the occurrence of peritonsillar abscess (PTA) and peritonsillar cellulitis (PTC). A Strep A test was performed in 61% (229/376) of the events studied. Strep A was positive in 22% of PTA events and in 35% of PTC events (p=0.036). Of 48,000 Strep A tests taken in primary healthcare, mainly for sore throat, 22% were positive. We examined the relationship between age, the incidence of PTA, and positive Strep A tests. We also determined if there was a monthly correlation between number of positive Strep A tests and number of PTA events. We found no significant correlations. In conclusion, our findings indicate that GAS does not play a major role in the development of PTA/PTC.

  • 18.
    Söderquist, Bo
    Örebro universitet, Institutionen för läkarutbildning. Region Örebro län. The Departments of Laboratory Medicine, Clinical Microbiology, Örebro University Hospital, Örebro, Sweden; Infectious Diseases, Örebro University Hospital, Örebro, Sweden.
    Prosthetic hip joint infection caused by non-capsulated Haemophilus influenzae2014Ingår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 46, nr 9, s. 665-668Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Haemophilus influenzae is rarely described as a causative agent of prosthetic joint infections. Here, a case of prosthetic hip joint infection caused by H. influenzae is reported. Treatment was successful, resulting in implant salvage, by debridement and antibiotic treatment with ciprofloxacin as monotherapy for 3 months.

  • 19.
    Söderquist, Bo
    et al.
    Örebro universitet, Hälsoakademin.
    Berglund, C.
    Simultaneous presence of an invasive and a carrier strain of methicillin-resistant Staphylococcus aureus (MRSA) in a family2008Ingår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 40, nr 11-12, s. 987-989Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Simultaneous carriage of multiple clones of MRSA has rarely been reported. We describe a case of bacteraemia and osteomyelitis due to CA-MRSA and the simultaneous presence of 2 clones of MRSA in a family, 1 strain with an invasive capacity and another strain colonizing several family members.

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