Outbreak of a beta-lactam resistant non-typeable Haemophilus influenzae sequence type 14 associated with severe clinical outcomes.

BACKGROUND: During October 2011 several residents and staff members at a long-term care facility (LTCF) for elderly fell ill with respiratory symptoms. Several of the residents required hospitalization and one died. Non-typeable Haemophilus influenzae (NTHi) was identified as the causative pathogen. METHODS: A descriptive analysis of the outbreak and countermeasures was performed. For each identified bacterial isolate implied in the outbreak, standard laboratory resistance testing was performed, as well as molecular typing and phylogenetic analysis. RESULTS: The identified H. influenzae was beta-lactamase negative but had strikingly high MIC-values of ampicillin, cefuroxime and cefotaxime. All isolates displayed the same mutation in the ftsI gene encoding penicillin-binding protein (PBP) 3, and all but one were identified as sequence type 14 by Multilocus Sequence Typing (MLST). In total 15 individuals in connection to the LTCF; 8 residents, 6 staff members and one partner to a staff member were colonized with the strain. CONCLUSION: This report illustrates the existence of non-typeable H. influenzae with high virulence, and furthermore emphasizes the importance of continuous surveillance of possible outbreaks in health care facilities and prompt measures when outbreaks occur.

Possible zoonotic transmission of Cryptosporidium felis in a household.

In humans, the risk of contracting cryptosporidiosis caused by Cryptosporidium felis is considered to be relatively low, and most of the confirmed cases have been observed in immunocompromised patients. Both anthroponotic and zoonotic transmission routes have been suggested. Here, we report a case of suspected zoonotic transmission of C. felis from a cat to a human. The cat developed diarrhea several months before such symptoms were displayed by its owner, a 37-year-old immunocompetent woman. The presence of identical C. felis SSU rRNA, HSP70, and COWP gene sequences was verified in both hosts. In conclusion, it is highly probable that the cat was the initial source of infection and not the opposite. Our results show that Cryptosporidium infection can be transmitted from pets to humans and that molecular analysis is needed to confirm the identity of the oocysts.

[Results of the hepatitis A epidemic in Blekinge. Transmission links surveyed with the help of sequence analysis of viral RNA]. / Facit för hepatit A-epidemi i Blekinge. Smittsambanden kartlades med hjälp av sekvensanalys av viralt RNA.

In 1994-1995 there was an epidemic of hepatitis A (HAV) among drug abusers in the county of Blekinge, Sweden. There were also a number of other cases in which the epidemiological links were unclear. In order to uncover possible links between unclear cases retrospective sequencing was carried out of the VP1 region of HAV-RNA from patient sera. It was found that the epidemic among drug abusers spread beyond their closest contacts, revealing links that would otherwise not have been suspected. The extent of the epidemic also demonstrated the need to vaccinate injecting drug users against hepatitis A.