Feline infectious peritonitis (FIP) caused by feline coronavirus (FCoV) is a common dis-ease in cats, fatal if untreated, and no effective treatment is currently legally available. The aim of this study was to evaluate efficacy and toxicity of the multi-component drug Xraphconn® in vitro and as oral treatment in cats with spontaneous FIP by examining survival rate, development of clinical and laboratory parameters, viral loads, anti-FCoV antibodies, and adverse effects. Mass spectrometry and nuclear magnetic resonance identified GS-441524 as an active component of Xraphconn®. Eighteen cats with FIP were prospectively followed up while being treated orally for 84 days. Values of key parameters on each examination day were compared to values before treatment initiation using linear mixed-effect models. Xraphconn® displayed high virucidal activity in cell culture. All cats recovered with dramatic improvement of clinical and laboratory parameters and massive reduction in viral loads within the first few days of treatment without serious adverse effects. Oral treatment with Xraphconn® containing GS-441524 was highly effective for FIP without causing serious adverse effects. This drug is an excellent option for the oral treatment of FIP and should be trialed as potential effective treatment option for other severe coronavirus-associated diseases across species.

Background: The analysis of phenotypic characteristics on Mycobacterium tuberculosis (MTB)-specific T cells is a promising approach for the diagnosis of active tuberculosis (aTB) and for monitoring treatment success. We therefore studied phenotypic changes on MTB-specific CD4 T cells upon anti-tuberculosis treatment initiation in relation to the treatment response as determined by sputum culture.Methods: Peripheral blood mononuclear cells from subjects with latent MTB infection (n = 16) and aTB (n = 39) at baseline, weeks 9, 12, and 26 (end of treatment) were analyzed after intracellular interferon gamma staining and overnight stimulation with tuberculin. Liquid sputum cultures were performed weekly until week 12 and during 4 visits until week 26.Results: T cell activation marker expression on MTB-specific CD4 T cells differed significantly between subjects with aTB and latent MTB infection with no overlap for the frequencies of CD38pos and Ki67pos cells (both p < 0.0001). At 9 weeks after anti-TB treatment initiation the frequencies of activation marker (CD38, HLA-DR, Ki67) positive MTB-specific, but not total CD4 T cells, were significantly reduced (p < 0.0001). Treatment induced phenotypic changes from baseline until week 9 and until week 12 differed substantially between individual aTB patients and correlated with an individual's time to stable sputum culture conversion for expression of CD38 and HLA-DR (both p < 0.05). In contrast, the frequencies of maturation marker CD27 positive MTB-specific CD4 T cells remained largely unchanged until week 26 and significantly differed between subjects with treated TB disease and latent MTB infection (p = 0.0003).Discussion: Phenotypic changes of MTB-specific T cells are potential surrogate markers for tuberculosis treatment efficacy and can help to discriminate between aTB (profile: CD38pos, CD27low), treated TB (CD38neg, CD27low), and latent MTB infection (CD38neg, CD27high).

Background The prescription rate of antibiotics is high for febrile children visiting the emergency department (ED), contributing to antimicrobial resistance. Large studies at European EDs covering diversity in antibiotic and broad-spectrum prescriptions in all febrile children are lacking. A better understanding of variability in antibiotic prescriptions in EDs and its relation with viral or

Our data demonstrate that implementation of an ASP was associated with a profound improvement of rational antibiotic use and, therefore, patient safety. Considering the relatively short observation period, the long-term effects of our ASP bundle need to be further investigated.

We report 15 imported louse-borne relapsing fever (LBRF) cases in refugees in Bavaria, Germany. One patient died. Epidemiological findings confirmed that all were young males from the Horn of Africa (12 from Somalia), who had similar migration routes converging in Sudan continuing through Libya and Italy. The majority likely acquired their infection during migration. Healthcare workers should be aware of LBRF in refugees passing through north Africa to ensure correct treatment and preventive measures.

Recently, epidemiological data shows an increase of childhood tuberculosis in Germany. In addition to this, drug resistant tuberculosis becomes more frequent. Therefore, diagnosis, prevention and therapy in childhood and adolescence remain a challenge. Adult guidelines do not work for children, as there are age specific differences in manifestation, risk of progression and diagnostic as well as therapeutic pathways.The German Society for Pediatric Infectious Diseases (DGPI) has initiated a consensus-based (S2k) process and completed a paediatric guideline in order to improve and standardize care for children and adolescents with tuberculosis exposure, infection or disease.Updated dosage recommendations take age dependant pharmacokinetics in the treatment of drug sensitive but also drug resistant tuberculosis in account. In addition to this, there is a detailed chapter on perinatal exposure and disease as well as extrapulmonary manifestations.

One hundred ninety-three Streptococcus agalactiae isolates of neonatal origin and 146 isolates from adult women were analyzed for macrolide resistance and investigated for clonality. Among erythromycin-resistant isolates, serotype V turned out to be the most frequent. Comparative pulsed-field gel electrophoresis analysis revealed genetic clustering of resistant strains and predominance of a single clone family within an otherwise heterogeneous serotype V population. [GBS]) is the leading cause of meningitis and early-onset sepsis in neonates (3,21). Penicillin or ampicillin is the drug of choice for prophylaxis and treatment of GBS disease (1, 5). However, erythromycin and clindamycin are the recommended second-line drugs and the first alternative in case of a ␤-lactam allergy. In recent years, increasing macrolide resistance rates have been reported (9,15,16,17,19). Resistance mechanisms include target site modification mediated by erm genes leading to resistance to macrolides-lincosamides-streptogramin B (MLS phenotype) with either inducible or constitutive expression or an efflux mechanism encoded by mef genes mediating resistance only to 14-and 15-membered macrolides (M phenotype). After the first description of serotype V in 1977 (26), several studies reported a major increase of serotype V GBS among clinical isolates in the early 1990s (8,13). To analyze the recent increase in macrolide resistance among GBS isolates in our region, the present study aimed to explore the issue of a clonal spread of resistant strains by means of randomly amplified polymorphic DNA (RAPD) analysis and restriction digest patterns (RDP) derived from pulsed-field gel electrophoresis (PFGE). Moreover, a possible correlation between the increase of a certain serotype and macrolide resistance was explored. Streptococcus agalactiae (group B StreptococcusThe bacterial strains used in this study have been presented previously (20). In brief, of 193 neonatal GBS strains, 26 invasive isolates were cultured from blood or cerebrospinal fluid while 167 isolates were grown from urine samples and swab cultures. A total of 146 GBS isolates from vaginal swabs of pregnant women were randomly collected. Serotyping was performed by using an enzymatic extraction method (2). All erythromycin-resistant isolates were screened by PCR analysis for erythromycin resistance genes (mefA or mefE, ermB, and ermTR) by using primers previously described (7,23,24). PCR assays were reproducibly repeated at least three times for every strain. Differentiation of specific MLS phenotypes was performed by use of a triple-disk test (10). For RAPD analysis, the core sequence of phage M13 and the previously described primer OPS16 were used (6, 12) and visual inspection of bands served to compare RAPD patterns for similarity. Different isolates with the same migration distances of all visible bands were considered highly similar. The presence or absence of two distinct bands was deemed to indicate a difference. Chromosomal DNA of GBS strains was prepared by modifications o...

Between 2015 and 2017, an estimated 200,000 to 400,000 children were seeking asylum each year in EU/EEA countries. As access to high-quality health care is important, we collected and compared current recommendations across Europe for a consensus recommendation on medical care for migrant children. Existing recommendations were collected from published literature and identified through national representatives from paediatric societies of 31 EU/EEA countries. In addition, guidelines from Australia, Canada, and the United States were reviewed. Evidence on recommendations to be considered for inclusion was specifically identified in literature searches focused on recent evidence from Europe. For eight EU/EEA countries a national recommendation was identified. Growth and development, vision and hearing impairment, skin and dental problems, immunisations, anemia, micronturient deficiency, helminths, hepatitis B and C, human immunodeficiency virus, malaria, schistosomiasis, syphilis, tuberculosis, posttraumatic stress disorder and sexual health were most frequently mentioned and therefore selected for inclusion in the recommendation. Conclusion: The current document provides recommendations based on expert opinion and evidence for medical care for migrant children in Europe. These include general topics on ethical standards, use of interpreters, follow-up and documentation and specific recommendations for communicable and non-communicable conditions and diseases. Keywords ; The author would like to thank Ayesha Kadir and Anders Hjern for helpful comments on the manuscript. We would like to thank René-Marie Meignan for designing the icons.