We report a human case of Borrelia miyamotoi infection diagnosed in Austria. Spirochetes were detected in Giemsa-stained blood smears. The presence of B. miyamotoi in the patient’s blood was confirmed by PCR, and phylogenetic analysis identified an infection with a strain from Europe.

Toxocara spp. are zoonotic parasites with global distribution infecting humans by incidental ingestions of eggs shed in feces of dogs or cats. High seroprevalences have been reported from several regions of Africa, however data from the Central African region remain limited. Although several clinical entities caused by larvae of Toxocara spp. have been described, the public heath impact of this infection has so far often been neglected. This study was conducted to estimate the prevalence in a rural central African population. The population based study was performed in volunteers in a rural region of Gabon. A two-step testing approach was applied using an ELISA as screening test and a Western Blot (immunoblot) as confirmatory assay. Basic demographic data and risk factors were collected and compared between seropositive and negative participants. In total, 199 out of 332 serum samples were tested positive for Toxocara spp. antibodies (59.9%). After standardization for age to the overall Gabonese population seroprevalence was 53.6% (95% CI 48.2-59.0%). There was a trend towards higher seroprevalence in participants with agricultural activity. Seroprevalence of antibodies against Toxocara spp. is high in this rural population in Gabon. These results are comparable with previous reports from other sub-regions of Africa and add to our understanding of the epidemiology of toxocariasis in Africa. Given the high prevalence of toxocariasis in tropical regions, it may be speculated that clinically relevant presentations (e.g. visceral or ocular larva migrans syndrome) may occur in considerable numbers. A formal assessment of the burden of disease and the public health impact of human toxocariasis is therefore warranted.

The clinical role of vitamin D in sepsis and mortality prediction is controversially discussed. Therefore, we conducted a prospective cohort study on standard care wards, including 461 patients with suspected sepsis fulfilling two or more SIRS criteria. On the first and third day after onset of SIRS symptoms levels of 25(OH)D, 1,25(OH)D and sepsis biomarkers were analysed for their predictive capacity for identifying infection, bacteraemia and an elevated mortality risk. Additionally, several SNPs associated with vitamin D metabolism were evaluated. Bacteraemic patients (28.5%) presented with significantly lower 1,25(OH)D levels than SIRS patients without bacteraemia on the first and third day, while 25(OH)D did not show a predictive capacity. No significant differences of either 1,25(OH)D or 25(OH)D levels were found between SIRS patients with and without infections or between survivors and non-survivors. Sepsis biomarkers, including procalcitonin and CRP, showed a significantly higher discriminatory capacity for these classification tasks. The vitamin D metabolism-related SNPs analysed did not indicate any association with our outcome measures. In conclusion, 1,25(OH)D but not 25(OH)D showed a minor discriminatory value for the prediction of bacteraemia that was inferior to CRP and PCT but both failed to predict sepsis and mortality in a prospective cohort of SIRS patients.

Intraperitoneal administration of antibiotics together with peritoneal dialysis fluids (PDFs) remains the preferable route for treatment of peritoneal dialysis-related peritonitis. For home based therapy, antibiotic-containing PDFs are stored for up to two weeks and warmed up to body-temperature before administration. The present study investigated the compatibility of ciprofloxacin with five commercial PDFs at refrigeration-temperature, room-temperature and body-temperature. Ciprofloxacin concentrations were determined using high-performance liquid chromatography. Drug-diluent stability was evaluated by measurement of pH-values and visual inspection at each sampling point. The antimicrobial activity of ciprofloxacin was assessed by an E. coli disk diffusion method. Ciprofloxacin was stable at refrigeration-temperature and body-temperature in all PDFs evaluated over the whole study period of 14 days and 24 hours, respectively. At room-temperature, in contrast, ciprofloxacin demonstrated only limited stability in particular when tested in mixed Physioneal. Except for Physioneal 1.36%, no relevant drug adsorption was observed and the antimicrobial activity of ciprofloxacin was found to be preserved in each PDF at each storage condition investigated. Intraperitoneal ciprofloxacin might be used for inpatient and home based therapy of peritoneal dialysis-related peritonitis and no compensatory dose adjustment is needed when stored for up to two weeks at refrigeration-temperature before use.

the preferable route for treatment of peritoneal dialysis related peritonitis remains the intraperitoneal administration of antibiotics admixed to peritoneal dialysis fluids. It is important to know whether the administered drug is compatible with the PD fluids and its container. In the present study the compatibility of aztreonam with four commercial PDFs at storing temperatures and duration representative for storing conditions in the clinical settings was investigated. Aztreonam concentrations were determined using high-performance liquid chromatography. The antimicrobial activity of aztreonam was evaluated using an E. coli diffusion disk inhibition assay and P. aeruginosa time-kill curves. In Extraneal evaluated at 6 °C, 25 °C and 37 °C aztreonam was stable over the whole study period of 14 days and 24 hours, respectively. In Physioneal and Nutrineal aztreonam was stable at 6 °C for up to 14 days. Antimicrobial activity was retained in all PD fluids over the whole study period. Aztreonam remained stable and was compatible with the PD fluids, particularly with Extraneal or Nutrineal, and no compensatory dose adjustment is needed when stored for up to 14 days at refrigeration temperature before use. Bacterial peritonitis is a serious complication of peritoneal dialysis (PD) which often leads to membrane failure and patients discontinuing from peritoneal dialysis and switching to hemodialysis 1. The most common bacteria isolated from patients with PD associated peritonitis (PDAP) are primarily Gram-positive cocci like Staphylococci or Streptococci, but also Gram-negative bacteria like Escherichia coli or Pseudomonas aeruginosa are frequently detected 2. Particularly P. aeruginosa peritonitis is generally severe and associated with higher frequencies of hospitalization, catheter removal and transfer from PD to hemodialysis (HD) 3-5. Thus, empiric antimicrobial therapy should cover both, the most likely Gram-positive and Gram-negative bacteria. Aztreonam is the only clinically available monobactam with its antibacterial spectrum limited to Gram-negative aerobic bacteria and could be of strong use for the treatment of Gram-negative PDAP. In case of a P. aeruginosa peritonitis the current International Society for Peritoneal Dialysis (ISPD) guidelines suggest treating with two antibiotic agents with different mechanisms of action for three weeks 1. Therefore, aztreonam might be a feasible alternative to cephalosporins or fluoroquinolones, especially due increasing rate of multidrug-resistant Gram-negative bacteria 6. Intraperitoneal (i.p.) administration of drugs is preferable to intravenous or oral routes in PDAP due to the markedly higher concentrations achieved at the target site 1. In the past, aztreonam was assumed to be more cost intensive and more difficult to handle in continuous ambulatory peritoneal dialysis (CAPD), especially compared to fluroquinolones, since it must be administered four times daily 7,8. However, more recent studies have shown that once a day i.p. administration provides sufficient serum...