Optimizing Shiga toxin-producing Escherichia coli diagnostics, prevention and treatment
Shiga toxin-producing Escherichia coli (STEC) can cause human infections ranging from asymptomatic carriage to bloody diarrhea (BD) and fatal hemolytic uremic syndrome (HUS). HUS is the most common cause of acute kidney failure in children. There is an urgent need of developing methods to predict disease severity already at microbial diagnosis to optimize treatment and infection control measures. We use a translational approach to investigate the molecular basis of STEC virulence to predict disease severity already at diagnosis including comparative genomic analysis.
Tobramycin resistant Staphylococcus aureus in a neonatal intensive care unit
Staphylococcus aureus is responsible for outbreaks at neonatal intensive care units (NICUs). Invasive infections are the most common causes of death at NICUs among neonates worldwide and stand for approximately 36 % of the estimated 4 million neonates’ deaths annually worldwide. At present we investigate an endemic situation with tobramycin resistant S. aureus at a NICU and we plan national surveillance studies to reveal the spread of resistant S. aureus in NICUs.
The spread of Clostridioides difficile in hospital settings and investigations of virulence
Clostridioides difficile is a major cause of nosocomial diarrhea and pseudomembranous colitis. Some C. difficile ribotypes (RT) have been described as hyper virulent and especially RT 027 (B1/NAP1) has been associated with large outbreaks with severe outcome in North and South America, Europe, Asia and Australia since 2001. In recent work, we have defined strains more prone to spread in hospital environments and cause relapses. At present we investigate an insidious outbreak of C. difficile infection (CDI) in a Swedish hospital, caused by the multi-drug resistant and highly virulent RT 046.
Prevalence of the diarrhea-causing intestinal protozoa and improvement of diagnostics
In cases of acute gastroenteritis, identification of the infectious agent can be of importance for patient management and for surveillance leading to early discovery of potential outbreaks that can be harmful for individuals and the community. The prevalence of the diarrhea-causing intestinal protozoa such as Giardia intestinalis, Cryptosporidium spp, Cyclospora cayetanensis and Entamoeba histolytica is not well understood and several factors like methodology, geographical setting, population and testing algorithms are likely to influence the data. We focus on the understanding of the occurrence of intestinal protozoa in patients with diarrhea and the improvement of diagnostic methods including testing algorithms.