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Acute epiglottitis--aetiology, epidemiology and outcome in a population before large-scale Haemophilus influenzae type b vaccination.

https://arctichealth.org/en/permalink/ahliterature35639
Source
Clin Otolaryngol Allied Sci. 1994 Oct;19(5):441-5
Publication Type
Article
Date
Oct-1994
Author
S. Hugosson
P. Olcén
C. Ekedahl
Author Affiliation
Department of Otorhinolaryngology, Orebro Medical Center Hospital, Sweden.
Source
Clin Otolaryngol Allied Sci. 1994 Oct;19(5):441-5
Date
Oct-1994
Language
English
Publication Type
Article
Keywords
Acute Disease
Adolescent
Adult
Child
Child, Preschool
Comparative Study
Epiglottitis - epidemiology - etiology - immunology
Female
Haemophilus Vaccines - immunology
Haemophilus influenzae - immunology - pathogenicity
Humans
Incidence
Infant
Infant, Newborn
Male
Research Support, Non-U.S. Gov't
Retrospective Studies
Sweden - epidemiology
Vaccination
Abstract
Over a period of 18 years 219 consecutive cases of acute epiglottitis were diagnosed and subsequently investigated in order to elucidate the aetiology, epidemiology and outcome of this disease in a well-defined population in Sweden before general vaccination against Haemophilus influenzae type b infection was introduced. Compared with the results from other parts of the industrialized world, high incidence rates were found in both children (14/100,000/year) and adults (2.3/100,000/year). The annual trend showed a significant decline in incidence among children, whereas in adults it remained unchanged. In cases where the aetiological agent could be determined, infection with H. influenzae type b was the main cause of disease in all age groups. However, in adults 27% (6/22) had a disease caused by micro-organisms other than H. influenzae type b that were verified with a blood culture. Sixty-eight per cent had a negative blood culture. The mortality rate was 0.5% (1/219) and 6% (13/219) developed a significant complication of the disease.
PubMed ID
7834888 View in PubMed
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Amplification of DNA by the polymerase chain reaction for the efficient diagnosis of pertussis.

https://arctichealth.org/en/permalink/ahliterature36891
Source
Scand J Infect Dis. 1992;24(3):339-45
Publication Type
Article
Date
1992
Author
P. Olcén
A. Bäckman
B. Johansson
E. Esbjörner
E. Törnqvist
J. Bygraves
W L McPheat
Author Affiliation
Department of Clinical Microbiology and Immunology, Orebro Medical Center Hospital, Sweden.
Source
Scand J Infect Dis. 1992;24(3):339-45
Date
1992
Language
English
Publication Type
Article
Keywords
Base Sequence
Bordetella pertussis - genetics - isolation & purification
Child
Child, Preschool
DNA, Bacterial - genetics
Female
Humans
Infant
Male
Molecular Sequence Data
Polymerase Chain Reaction
Research Support, Non-U.S. Gov't
Sweden
Whooping Cough - diagnosis
Abstract
The standard diagnostic methods for pertussis have several shortcomings. With the increased knowledge of the Bordetella pertussis genome a specific and conserved DNA sequence, present in about 70-80 copies in each genome, was selected for amplification with the polymerase chain reaction (PCR) technique in order to evaluate its diagnostic potential in children with suspected pertussis. The 400 basepair DNA sequence chosen was present and amplified in all 112 B. pertussis strains and in no other bacterial species examined. The specificity of the amplified material was documented by restriction enzyme cleavage. In nasopharyngeal aspirates a B. pertussis specific PCR product was visualized in 19/25 culture positive and in 5/50 culture negative children. In conclusion the present PCR assay for B. pertussis can be clinically useful and permit a specific diagnosis within 1 day after sampling. Further studies are requested to document its sensitivity, specificity and predictive value for positive and negative results.
PubMed ID
1509238 View in PubMed
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Characterization of Chlamydia trachomatis omp1 genotypes among sexually transmitted disease patients in Sweden.

https://arctichealth.org/en/permalink/ahliterature192697
Source
J Clin Microbiol. 2001 Nov;39(11):3915-9
Publication Type
Article
Date
Nov-2001
Author
M. Jurstrand
L. Falk
H. Fredlund
M. Lindberg
P. Olcén
S. Andersson
K. Persson
J. Albert
A. Bäckman
Author Affiliation
Department of Clinical Microbiology and Immunology, Orebro Medical Centre Hospital, SE-70185 Orebro, Sweden. margaretha.jurstrand@orebroll.se
Source
J Clin Microbiol. 2001 Nov;39(11):3915-9
Date
Nov-2001
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Ambulatory Care
Bacterial Typing Techniques
Chlamydia Infections - diagnosis - epidemiology - microbiology
Chlamydia trachomatis - classification - genetics - metabolism
Female
Female Urogenital Diseases - diagnosis - epidemiology - microbiology
Genotype
Humans
Male
Male Urogenital Diseases
Middle Aged
Phylogeny
Polymerase Chain Reaction
Porins - genetics
Sequence Analysis, DNA
Sexually Transmitted Diseases, Bacterial - diagnosis - epidemiology - microbiology
Sweden - epidemiology
Urine - microbiology
Urogenital System - microbiology
Abstract
A method for detection and genotyping of genital Chlamydia trachomatis infections based on omp1 gene amplification and sequencing was developed. DNA was extracted from urogenital or urine samples using a Chelex-based method, and an approximately 1,100-bp-long fragment from the omp1 gene was directly amplified and sequenced. Genotyping was performed by BLAST similarity search, and phylogenetic tree analysis was used to illustrate the evolutionary relationships between clinical isolates and reference strains. The method was used to determine the genotypes of C. trachomatis in 237 positive urogenital and/or urine specimens collected at a Swedish sexually transmitted disease clinic during 1 year. The most common genotypes corresponded to serotypes E (47%) and F (17%). The omp1 gene was highly conserved for genotype E (106 of 112 samples without any mutation) and F (41 of 42 samples without any mutation) strains but appear slightly less conserved for genotypes G (n = 6) and H (n = 6), where the sequences displayed one to four nucleotide substitutions relative to the reference sequence. Genotyping of samples collected at the follow-up visit indicated that two patients had become reinfected, while three other patients suffered treatment failure or reinfection. One woman appeared to have a mixed infection with two different C. trachomatis strains. This omp1 genotyping method had a high reproducibility and could be used for epidemiological characterization of sexually transmitted Chlamydia infections.
Notes
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PubMed ID
11682507 View in PubMed
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Characterization of epidemic and nonepidemic Neisseria meningitidis serogroup A strains from Sudan and Sweden.

https://arctichealth.org/en/permalink/ahliterature37611
Source
J Clin Microbiol. 1990 Aug;28(8):1711-9
Publication Type
Article
Date
Aug-1990
Author
M A Salih
D. Danielsson
A. Bäckman
D A Caugant
M. Achtman
P. Olcén
Author Affiliation
Department of Paediatrics and Child Health, Faculty of Medicine, University of Khartoum, Sudan.
Source
J Clin Microbiol. 1990 Aug;28(8):1711-9
Date
Aug-1990
Language
English
Publication Type
Article
Keywords
Antigenic Variation - genetics
Bacterial Outer Membrane Proteins - genetics
Child
Disease Outbreaks
Fimbriae, Bacterial - immunology
Genotype
Humans
Lipopolysaccharides - genetics
Meningitis - epidemiology - genetics - immunology
Neisseria meningitidis - classification - genetics - immunology
Phenotype
Prevalence
Research Support, Non-U.S. Gov't
Restriction Mapping
Sudan - epidemiology
Sweden - epidemiology
Abstract
A random selection of 25 strains isolated during an epidemic caused by serogroup A Neisseria meningitidis in Sudan (1988), 3 preepidemic meningococcal strains (1985), and 26 serogroup A strains isolated from sporadic cases of meningitis in Sweden (1973 to 1987) were assessed for multilocus enzyme genotypes (ETs), DNA restriction enzyme patterns, outer membrane proteins, lipopolysaccharides, pilus formation, and antibiograms. All of the 25 Sudanese epidemic isolates and 22 of the Swedish strains were of the same or closely related ETs (ETs 3, 4, and 5), corresponding to clone III-1, which has been responsible for two pandemic waves in the last three decades. The earlier pandemic involved Scandinavia, and the last one caused an outbreak during the pilgrimage to Mecca, Saudi Arabia (August 1987), spreading to Sudan, Chad, and Ethiopia. The three Sudanese preepidemic isolates (1985) were clone IV-1 (sulfonamide susceptible), which has been resident in the African meningitis belt for the last 25 years. The uniformity of clone III-1 strains (all sulfonamide resistant) from Sudan and Sweden was confirmed by DNA restriction enzyme patterns. ETs 3, 4, and 5 from Sudan and Sweden had 86 to 100% similarity to a Swedish clone III-1 reference strain, whereas ETs 1, 2, 6, and 7 showed 50 to 80% similarity. Class 1 protein for clone III-1 showed serosubtype antigens P1.9 and P1.x, whereas ET6 strains (clone IV-1) had serosubtype P1.7. Lipopolysaccharides were variable in the Sudanese and Swedish strains. Pili were expressed in all clone III-1 isolates from Sudan and Sweden but in none of the clone IV-1 isolates (Sudan, 1985).
PubMed ID
1975593 View in PubMed
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Clinical presentation of invasive disease caused by Neisseria meningitidis serogroup Y in Sweden, 1995 to 2012.

https://arctichealth.org/en/permalink/ahliterature283821
Source
Epidemiol Infect. 2017 Jul;145(10):2137-2143
Publication Type
Article
Date
Jul-2017
Author
O. Säll
B. Stenmark
M. Glimåker
S. Jacobsson
P. Mölling
P. Olcén
H. Fredlund
Source
Epidemiol Infect. 2017 Jul;145(10):2137-2143
Date
Jul-2017
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Child
Child, Preschool
Female
Humans
Incidence
Infant
Infant, Newborn
Male
Meningitis, Meningococcal - epidemiology - microbiology
Meningococcal Infections - epidemiology - microbiology
Middle Aged
Neisseria meningitidis, Serogroup Y - classification - physiology
Retrospective Studies
Sweden - epidemiology
Young Adult
Abstract
Over the period 1995-2012, the incidence of invasive meningococcal disease (IMD) caused by Neisseria meningitidis serogroup Y (NmY) increased significantly in Sweden. This is mainly due to the emergence of a predominant cluster named strain type YI subtype 1, belonging to the ST-23 clonal complex (cc). The aim of this study was to examine the clinical picture of patients with invasive disease caused by NmY and to analyse whether the predominant cluster exhibits certain clinical characteristics that might explain the increased incidence. In this retrospective observational study, the medical records available from patients with IMD caused by Nm serogroup Y in Sweden between 1995 and 2012 were systematically reviewed. Patient characteristics, in-hospital findings and outcome were studied and differences between the dominating cluster and other isolates were analysed. Medical records from 175 of 191 patients were retrieved. The median age was 62 years. The all-cause mortality within 30 days of admission was 9% (15/175) in the whole material; 4% (2/54) in the cohort with strain type YI subtype 1 and 11% (12/121) among patients with other isolates. Thirty-three per cent of the patients were diagnosed with meningitis, 19% with pneumonia, 10% with arthritis and 35% were found to have bacteraemia but no apparent organ manifestation. This survey included cases with an aggressive clinical course as well as cases with a relatively mild clinical presentation. There was a trend towards lower mortality and less-severe disease in the cohort with strain type YI subtype 1 compared with the group with other isolates.
PubMed ID
28478773 View in PubMed
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Different seroprevalences of antibodies against Neisseria meningitidis serogroup A and Haemophilus influenzae type b in Sudanese and Swedish children.

https://arctichealth.org/en/permalink/ahliterature36305
Source
Epidemiol Infect. 1993 Apr;110(2):307-16
Publication Type
Article
Date
Apr-1993
Author
M A Salih
H. Fredlund
S. Hugosson
L. Bodin
P. Olcén
Author Affiliation
Department of Paediatrics, Faculty of Medicine, University of Khartoum, Sudan.
Source
Epidemiol Infect. 1993 Apr;110(2):307-16
Date
Apr-1993
Language
English
Publication Type
Article
Keywords
Adolescent
Antibodies, Bacterial - analysis
Bacterial Capsules - immunology
Child
Child, Preschool
Comparative Study
Enzyme-Linked Immunosorbent Assay
Female
Haemophilus Infections - epidemiology - immunology
Haemophilus influenzae - immunology
Humans
Immunoglobulins - analysis
Infant
Male
Meningitis, Meningococcal - epidemiology - immunology
Neisseria meningitidis - immunology
Prevalence
Research Support, Non-U.S. Gov't
Sudan - epidemiology
Sweden - epidemiology
Abstract
Sampling of sera from 202 Sudanese and 124 Swedish children 1-14 years of age was conducted at the end of the 1980s presenting an opportunity to compare the seroprevalence of anti-Neisseria meningitidis (MC) serogroup A antibodies in an area immediately before outbreak of an epidemic (Sudan 1988) with a low endemic area (Sweden). An ELISA antibody assay was developed for detection of antibodies against capsular polysaccharide of MC serogroup A and Haemophilus influenzae type b (Hib). Serum antibody against MC serogroup A was found significantly more frequently in Sudanese than in Swedish children. This indicates that factors other than herd immunity, as measured by serum antibodies against MC serogroup A polysaccharide, are important for avoidance of an MC serogroup A epidemic. The seroprevalence of Hib antibodies was, in contrast, significantly higher in Swedish than in Sudanese children, especially for 5-9-year-old children. A possible explanation may be the different systems of day-care of children in the two countries.
PubMed ID
8472774 View in PubMed
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Epiglottitis in Sweden before and after introduction of vaccination against Haemophilus influenzae type b.

https://arctichealth.org/en/permalink/ahliterature33276
Source
Pediatr Infect Dis J. 1999 Jun;18(6):490-3
Publication Type
Article
Date
Jun-1999
Author
O. Garpenholt
S. Hugosson
H. Fredlund
L. Bodin
P. Olcén
Author Affiliation
Department of Clinical Microbiology, Orebro Medical Center Hospital, Sweden. orjan.garpenholt@orebroll.se
Source
Pediatr Infect Dis J. 1999 Jun;18(6):490-3
Date
Jun-1999
Language
English
Publication Type
Article
Keywords
Adult
Child
Epiglottitis - epidemiology - prevention & control - virology
Haemophilus Infections - epidemiology - prevention & control
Haemophilus Vaccines
Haemophilus influenzae type b - immunology
Humans
Incidence
Research Support, Non-U.S. Gov't
Retrospective Studies
Sweden - epidemiology
Vaccination
Abstract
BACKGROUND: Acute epiglottitis is an important manifestation of invasive Haemophilus influenzae type b (Hib) infection. In 1992 and 1993 Hib vaccination was introduced in the general childhood vaccination program in Sweden. The aim of the present investigation was to study the impact of Hib vaccination on the diagnosis of epiglottitis in Sweden in children as well as adults. METHODS: A retrospective national population-based study on the incidence of epiglottitis in Sweden was performed for the 10-year period 1987 to 1996. The incidence calculations were based on figures from the national register of all patients treated at Swedish hospitals. The incidence (cases/100,000/year) for the prevaccination period 1987 to 1991 was compared with the incidence after Hib vaccination was introduced. RESULTS: In children a substantial decrease was found after introduction of large scale vaccination against Hib. Below 5 years of age the annual incidence decreased from 20.9 in 1987 to 0.9 in 1996. In adults a tendency toward a decrease in incidence was evident. CONCLUSIONS: Introduction of Hib vaccination in a general childhood program was followed not only by a >90% reduction in the incidence in the youngest age group but also by a reduction in the incidence in the older age groups and among adults.
PubMed ID
10391176 View in PubMed
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Experiences with the new genetic variant of Chlamydia trachomatis in Orebro county, Sweden - proportion, characteristics and effective diagnostic solution in an emergent situation.

https://arctichealth.org/en/permalink/ahliterature160402
Source
Euro Surveill. 2007 Apr;12(4):E5-6
Publication Type
Article
Date
Apr-2007
Author
M. Unemo
P. Olcén
I. Agné-Stadling
A. Feldt
M. Jurstrand
B. Herrmann
K. Persson
P. Nilsson
T. Ripa
H. Fredlund
Author Affiliation
Department of Clinical Microbiology, Orebro University Hospital, Orebro, Sweden. magnus.unemo@orebroll.se
Source
Euro Surveill. 2007 Apr;12(4):E5-6
Date
Apr-2007
Language
English
Publication Type
Article
Keywords
Chlamydia trachomatis - genetics - isolation & purification
Chlamydiaceae Infections - diagnosis - epidemiology
Disease Outbreaks - prevention & control - statistics & numerical data
Genetic Variation - genetics
Humans
Incidence
Mutation
Population Surveillance - methods
Risk Assessment - methods
Risk factors
Sweden - epidemiology
Abstract
A Chlamydia trachomatis variant that contains a 377 bp deletion in the cryptic plasmid was recently reported in Sweden. This deletion includes the targets for Cobas Amplicor, Cobas TaqMan48, and Abbott m2000. We examined the proportion and characteristics of this variant in Orebro county, Sweden and developed an effective diagnostic solution. In total, 2,401 consecutive C. trachomatis culture samples and 536 PCR samples from symptomatic and asymptomatic patients and screened females were included. Culture, Cobas Amplicor, and LightMix 480HT were used for diagnosis. A mutant-specific PCR, plasmid sequencing, omp1 sequencing and multilocus sequence typing (MLST) were used to identify and characterise mutants. In total, 162 (6.7%) of the cultured samples were positive for C. trachomatis. However, 61 (38%) of those were negative when using Cobas Amplicor, and 60 of these were subsequently confirmed as the new variant. 13 of these mutant isolates were further characterised genetically, and all were of identical genotype E and the unique MLST sequence type: 21, 19, 1, 2, 1. Of all culture-positive samples, 161 of 162 were positive in the LightMix 480HT assay. The single negative sample was only weakly positive in culture, and negative in all PCRs. Of the 536 PCR samples, 37 were positive in both Cobas Amplicor and LightMix 480HT, 13 were only positive in LightMix 480HT (mutants), and two were only positive in Cobas Amplicor. Mutated C. trachomatis were prevalent in Orebro county in the period from October 2006 to February 2007, and it appeared to be a single clone. LightMix 480HT seemed sensitive, specific, and enabled high throughput diagnostics. However, rare low positive samples may be false-negative. Frequent surveillance and evaluations of diagnostic methods worldwide are crucial.
PubMed ID
17991387 View in PubMed
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Genetic characterisation of the emerging invasive Neisseria meningitidis serogroup Y in Sweden, 2000 to 2010.

https://arctichealth.org/en/permalink/ahliterature133660
Source
Euro Surveill. 2011;16(23)
Publication Type
Article
Date
2011
Author
S Thulin Hedberg
B. Törös
H. Fredlund
P. Olcén
P. Mölling
Author Affiliation
National Reference Laboratory for Pathogenic Neisseria, Department of Laboratory Medicine, Clinical Microbiology, orebro University Hospital, orebro, Sweden.
Source
Euro Surveill. 2011;16(23)
Date
2011
Language
English
Publication Type
Article
Keywords
Adult
Communicable Diseases, Emerging - genetics - mortality
Genetic Predisposition to Disease - epidemiology - genetics
Humans
Incidence
Meningitis, Meningococcal - genetics - mortality
Risk assessment
Risk factors
Sweden - epidemiology
Abstract
Neisseria meningitidis serogroups B and C have been responsible for the majority of invasive meningococcal disease in Europe. Recently, an increase of N. meningitidis disease due to serogroup Y has been noted in Sweden (in 2010, the proportion was 39%, with an incidence of 0.23 per 100,000 population), as well as in other northern European countries. We aimed to investigate the clonal pattern of the emerging serogroup Y in Sweden during 2000 to 2010. The serogroup Y isolates identified during this time (n=85) were characterised by multilocus sequence typing and sequencing of the fetA, fHbp, penA, porA and porB genes. The most frequent clone (comprising 28 isolates) with identical allele combinations of the investigated genes, was partly responsible for the observed increased number of N. meningitidis serogroup Y isolates. It was sulfadiazine resistant, with genosubtype P1.5-2,10-1,36-2, sequence type 23, clonal complex 23, porB allele 3-36, fetA allele F4-1, fHbp allele 25 and penA allele 22. The first case with disease due to this clone was identified in 2002: there was a further case in 2004, six during 2006 to 2007, eight during 2008 to 2009, with a peak of 12 cases in 2010. An unusual increase of invasive disease in young adults (aged 20?29 years) caused by this clone was shown, but no increase in mortality rate was observed.
PubMed ID
21679677 View in PubMed
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The impact of Haemophilus influenzae type b vaccination in Sweden.

https://arctichealth.org/en/permalink/ahliterature35032
Source
Scand J Infect Dis. 1996;28(2):165-9
Publication Type
Article
Date
1996
Author
O. Garpenholt
S A Silfverdal
S. Hugosson
H. Fredlund
L. Bodin
V. Romanus
P. Olcén
Author Affiliation
Department of Clinical Microbiology, Orebro Medical Centre Hospital, Sweden.
Source
Scand J Infect Dis. 1996;28(2):165-9
Date
1996
Language
English
Publication Type
Article
Keywords
Adult
Bacteremia - epidemiology - prevention & control
Child, Preschool
Comparative Study
Haemophilus Infections - epidemiology - prevention & control
Haemophilus Vaccines - administration & dosage - adverse effects
Humans
Immunization Programs - trends
Incidence
Infant
Infant, Newborn
Linear Models
Meningitis, Haemophilus - epidemiology - prevention & control
Polysaccharides, Bacterial - administration & dosage - adverse effects
Sweden - epidemiology
Abstract
The number of patients with meningitis and bacteremia due to Haemophilus influenzae was studied in Sweden over the period 1987-1994. Conjugated H. influenzae type b vaccines were introduced in Sweden in 1992, and all children born after December 31, 1992, were offered vaccination free of charge. A rapid decline of H. influenzae meningitis and bacteraemia was observed in the autumn of 1993, when the expected peak incidence failed to appear. In the prevaccination period 1987-1991, the average annual incidence (cases/100,000) was 34.4 in children aged 0-4 years. In 1994, the annual incidence fell to 3.5. No significant decline was observed in older children or adults. There was a 92% reduction in the number of meningitis cases and an 83% reduction in cases of bacteraemia. A similar decline was noted in 2 regions which followed different strategies for the introduction of the vaccination programme.
PubMed ID
8792484 View in PubMed
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26 records – page 1 of 3.