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The occurrence and genetic characterization of Cryptosporidium and Giardia species in foals in Belgium, The Netherlands, Germany and Greece.

Faecal samples were collected from foals between the age of 1 week and 6 months in Belgium, The Netherlands, Germany and Greece. A quantitative direct immunofluorescence assay based on the commercial MERIFLUOR Cryptosporidium/Giardia kit was performed to evaluate the presence of (oo) cysts. Parasite positive samples were genotyped, based on the 18S ribosomal DNA gene and the heat shock protein (HSP70) gene for Cryptosporidium and on the β-giardin gene and the triose phosphate isomerase (TPI) gene for Giardia. In total, 134 foals from Belgium, 44 foals from The Netherlands, 30 foals from German…

Impact of rotavirus vaccination in Germany: rotavirus surveillance, hospitalization, side effects and comparison of vaccines.

BACKGROUND: Although rotavirus (RV) vaccination was licensed in 2006, it was not included into the officially recommended German childhood vaccination schedule until 2013. Local differences in health policies in the past led to large differences in vaccination coverage rate among the federal states of Germany. This enables an ecologic study of RV vaccine effectiveness. METHODS: We performed a population-based retrospective analysis of RV vaccination use, RV notification and hospitalization among 0 to 5-year-old children in Germany during 2006 to 2011/2012. We compared effectiveness of the 2 R…

Abundance of Mycobacterium avium ssp. hominissuis in soil and dust in Germany - implications for the infection route.

UNLABELLED: The nontuberculous mycobacteria (NTM) are a heterogeneous group of bacteria found in soil, water and dust. The spread of NTM infection depends on the exposure to reservoirs with high proportions of mycobacteria, the virulence of the NTM strains, the enhanced sensitivity to infections such as those of immune-compromised hosts and patient risk factors such as Cystic Fibrosis. Since several decades, NTM lung disease has been increasingly observed in slender postmenopausal women. The most important NTM in Germany is Mycobacterium avium ssp. hominissuis (MAH). The routes of MAH infectio…

Bacterial spectrum of spontaneously ruptured otitis media in the era of pneumococcal conjugate vaccination in Germany.

UNLABELLED: Otitis media is a common pediatric disease and the main reason for antibiotic prescription in children. Before implementation of routine childhood pneumococcal vaccination in Germany, serotypes contained in the seven-valent pneumococcal conjugate vaccine (PCV) were among the most frequent pneumococcal serotypes responsible for acute otitis media (AOM). This report describes the first 3 years of a prospective, multicenter, epidemiological cross-sectional study examining the bacteriology of middle ear fluids (MEF) and nasopharyngeal swabs (NPS) of children 2 months to 5 years of age …

Patient relevant endpoints in oncology: current issues in the context of early benefit assessment in Germany.

UnlabelledThe German AMNOG healthcare reform includes a mandatory early-benefit-assessment (EBA) at launch. As per German social code, EBA is based on registration trials and includes evaluation of the patient-relevant effect of the new medicines compared to an appropriate comparator as defined by the Federal Joint Committee (G-BA). Current EBA decisions released have unveiled issues regarding the acceptance of some patient-relevant endpoints as G-BA and IQWiG are grading the endpoints, focusing on overall survival as the preferred endpoint in oncology.A taskforce of experienced German outcome

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… KG, Ingelheim, Germany; DK – Pfizer Pharma GmbH, Berlin, Germany; PK – MSD SHARP & DOHME GMBH, Haar, Germany; FL – Lilly Deutschland GmbH, Bad Homburg, Germany; JR – Roche Pharma AG, Grenzach-Wyhlen, Germany; DW – Janssen-Cilag GmbH, Neuss, Germany. … GmbH, Neuss, Germany. …

Survey of pediatricians in Germany reveals important challenges for possible implementation of meningococcal B vaccination.

Incidence of invasive meningococcal disease is low in Germany at 0.5 cases/100,000 inhabitants. Serogroup B (MenB) is most common, causing 70% of cases, with highest incidence in infants (5.9/100,000). In 2013, a MenB vaccine was licensed in Europe. To assess pediatricians' attitudes towards MenB vaccination and its potential use in Germany we conducted a nationwide cross-sectional survey among 5677 pediatricians. Of 3107 participants (response: 55%), 79.1% would recommend a MenB vaccination to parents, with 66.7% favoring a schedule at 6, 8 and 12 months over 2, 3, 4 and 12 months (13.4%). Ad…

Twenty years of active bat rabies surveillance in Germany: a detailed analysis and future perspectives.

In Germany, active bat rabies surveillance was conducted between 1993 and 2012. A total of 4546 oropharyngeal swab samples from 18 bat species were screened for the presence of EBLV-1- , EBLV-2- and BBLV-specific RNA. Overall, 0·15% of oropharyngeal swab samples tested EBLV-1 positive, with the majority originating from Eptesicus serotinus. Interestingly, out of seven RT-PCR-positive oropharyngeal swabs subjected to virus isolation, viable virus was isolated from a single serotine bat (E. serotinus). Additionally, about 1226 blood samples were tested serologically, and varying virus neutralizi…

Increase in opiate prescription in Germany between 2000 and 2010: a study based on insurance data.

BACKGROUND: Insufficient data have been available to date on the prevalence of opioid treatment in Germany, physicians' prescribing habits, and the percentages of cancer patients and non-cancer patients among those receiving opioids for an evaluation of the quality of care and an assessment of possible underuse or misuse. METHODS: The data analyzed in this study were derived from the statutory health insurance sample of the AOK health insurance company in the German state of Hesse / ASHIP Hesse for the years 2000-2010. For the purpose of this study, prevalence was defined as the percentage of…

Middle ear surgery in Thuringia, Germany: a population-based regional study on epidemiology and outcome.

OBJECTIVE: To evaluate population-based data on incidence and efficiency of middle ear surgery. STUDY DESIGN: Retrospective review. SETTING: All otolaryngology departments in one federal state in Germany. PATIENTS: All 1,037 middle ear surgeries performed in Thuringia in 2005. INTERVENTIONS: Middle ear surgery. MAIN OUTCOME MEASURE: Analysis of preoperative and postoperative audiometric results, preoperative diagnostics, and postoperative complications. Univariate statistical tests were used to analyze predictors for air-bone gap (ABG) improvement, complications, and need for resurgery. P…

Epidemiology of Streptococcus pneumoniae serogroup 6 isolates from IPD in children and adults in Germany.

This study presents serogroup 6 isolates from invasive pneumococcal disease (IPD) before and after the recommendation for childhood pneumococcal conjugate vaccination in Germany (July 2006). A total of 19,299 (children: 3508, adults: 15,791) isolates were serotyped. Serogroup 6 isolates accounted for 9.5% (children) and 6.7% (adults), respectively. 548 isolates had serotype 6A, 558 had serotype 6B, 285 had serotype 6C, and 4 had serotype 6D. Among children, serotype 6B was most prevalent (7.5% of isolates) before vaccination, followed by 6A and 6C. After the 7-valent pneumococcal conjugate vac…

Epidemiology of subacute sclerosing panencephalitis (SSPE) in Germany from 2003 to 2009: a risk estimation.

Subacute sclerosing panencephalitis (SSPE) is a fatal long-term complication of measles infection. We performed an estimation of the total number of SSPE cases in Germany for the period 2003 to 2009 and calculated the risk of SSPE after an acute measles infection. SSPE cases were collected from the Surveillance Unit for Rare Paediatric Diseases in Germany and the Institute of Virology and Immunobiology at the University of Würzburg. The total number of SSPE cases was estimated by capture-recapture analysis. For the period 2003 to 2009, 31 children with SSPE who were treated at German hospitals…

Caspofungin for treatment of invasive aspergillosis in Germany: results of a pre-planned subanalysis of an international registry.

BACKGROUND: This study is a pre-planned country-specific subanalysis of results in Germany from a multinational multicenter registry to prospectively assess real-world experience with caspofungin administered for treatment of proven or probable invasive aspergillosis (IA). METHODS: Data from patients treated with caspofungin for a single episode of IA were collected. Effectiveness was determined by the local investigator as favorable (complete or partial response) or unfavorable (stable disease, failure or death) at the end of caspofungin therapy. Descriptive statistics with binomial exact co…

Assessment of the human medical significance of the rabies zoonosis in Germany--analysis of available data and desiderata.

In order to assess the human medical significance of the rabies zoonosis in Germany, the data of the relevant surveillance and of the registration systems as well as prescriptions submitted to the statutory health insurance (SHI) were assessed. In all, 2441 of the 81 280 total examinations for rabies conducted on animals were performed subsequent to contact with humans. In this context 54% of exposures were attributed to wild animals and 46%, to domestic animals. In 2006 and 2007 there were still 0.42 and 0.34 veterinary medical analyses per 100 000 inhabitants, respectively, subsequent to hum…

Diagnostics and epidemiology of alveolar echinococcosis in slaughtered pigs from large-scale husbandries in Germany.

By means of the official meat inspection of domestic pigs, exceptionally high proportions of livers affected by encapsulated nodules containing whitish to light yellow, viscous to pasty material ("microabscesses") were detected. The swine had been raised on four different farms, being located in distinct regions of Germany (Brandenburg, Thuringia, Upper Franconia). Macroscopical and histological examination of 77 samples of livers revealed granulomatous to necrotizing hepatitis with attendance of numerous eosinophils. In 61 % (n = 47) of the lesions, eosinophilic, band-like acellular structure…

Distribution of rodenticide resistance and zoonotic pathogens in Norway rats in Lower Saxony and Hamburg, Germany.

BACKGROUND: Genetically based resistance to anticoagulants has led to increasing difficulties in the control of rodents over recent decades. The possible impact of rodenticide-resistant rats on the infection risk of humans and livestock by zoonotic pathogens is generally unknown. Hence, in a monitoring programme in the German federal states of Lower Saxony and Hamburg, more than 500 Norway rats were analysed for both Tyr139Cys polymorphisms within the VKORC1 gene and zoonotic agents. RESULTS: Evidence of resistance was almost completely restricted to the known resistance area in southern Lowe

[Development of length of stay and reimbursement in elective hand surgery after the introduction of DRGs in Germany].

BACKGROUND: Since its introduction in Germany, the DRG (Diagnosis-Related Groups) system is often fraught with negative connotations. Frequent points of criticism are a deterioration of patient care by decreasing length of stay (LOS) in hospital and a decline in reimbursement. The following investigation analyzes and compares the development of length of stay and reimbursement in hand surgery based on the 3 most common elective procedures. MATERIAL AND METHODS: The main diagnoses scaphoid nonunion (PSA), Dupuytren's contracture (DK) and rhizarthrosis (RIA) were evaluated for number of cases, …

[Excess mortality and prolongation of stay due to bloodstream infections caused by multiresistant pathogens in Germany].

BACKGROUND: Multiresistant pathogens cause substantial excess mortality and prolongation of hospital stay. However, until now there are no reliable estimates for Germany. METHOD: Based on data of three recent publications from Europe and current German data on bloodstream infections because of methicillin-resistant S. aureus (MRSA) and extended spectrum beta-lactamase (ESBL) producing E. coli we calculated the number of patients dying from bloodstream infections because of MRSA- instead of methicillin-susceptible S. aureus (MSSA) or ESBL-producing E. coli instead of non-ESBL E. coli. RESULTS…

Low social support and further risk factors for nicotine abuse in childhood and adolescence in Germany.

The health hazards of tobacco consumption are well known; numerous prevention programs exist, but knowledge of risk factors for starting to smoke is scarce. This study addressed the question if school-related factors influence smoking behavior in 7-17-year-old pupils. A cross-sectional study including 2459 pupils of schools in Rhineland-Palatinate, Germany, was conducted. Roughly every twentieth child (n = 135, 4.5%) had smoked at least once. In the multivariate model the probability of smoking was associated with older age, being male, not being content, and having inadequate family support, …

Evaluation of psychosocial distress in patients treated in a community-based oncology group practice in Germany.

BackgroundSystematic evaluation of psychosocial distress in oncology outpatients is an important issue. We assessed feasibility and benefit of standardized routine screening using the Distress Thermometer (DT) and Problem List (PL) in all patients of our community-based hematooncology group practice.Patients and methodsOne thousand four hundred forty-six patients were screened between July 2008 and September 2008. Five hundred randomly selected patients were sent a feedback form.ResultsThe average distress level was 4.7, with 37% indicating a distress level >5. Patients with nonmalignant disea

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… With this study, we wanted to explore the DT's and PL's feasibility in routine care of a community-based hematooncology group practice in Germany. During the last 20 years, >300 community-based hematooncology group practices have been established in Germany caring for >500 000 patients per year. … Since DT and PL never have been evaluated in routine care outside academic institutions, the aim of the study was to answer three main questions concerning routine patient care in a community-based hematooncology group practice in Germany: 1 Is it feasible to use the DT and PL in routine care? …

Management of atrial fibrillation by primary care physicians in Germany: baseline results of the ATRIUM registry.

BACKGROUND: In contrast to surveys in cardiologist settings, presentation and management of atrial fibrillation (AF) in primary care patients is less well studied. METHODS AND RESULTS: The prospective ATRIUM (Outpatient Registry Upon Morbidity of Atrial Fibrillation) collected data from patients with AF seen by 730 physicians representing a random sample of all primary care physicians in Germany. ATRIUM enrolled 3,667 patients (mean age, 72 ± 9 years; 58% male, mean CHADS(2) score 2.2 ± 1.3), 994 (27.1%) with paroxysmal, 944 (25.7%) with persistent or long-standing persistent and 1,525 (41.6%…