Publications
44 results found
Ruiz GB, Ross ZK, Holmes E, et al., 2019, Rapid and extensive karyotype diversification in haploid clinical Candida auris isolates, Current Genetics, Vol: 65, Pages: 1217-1228, ISSN: 0172-8083
Candida auris is a newly emerged pathogenic microbe, having been identified as a medically relevant fungus as recently as 2009. It is one of the most drug-resistant yeast species known to date and its emergence and population structure are unusual. Because of its recent emergence, we are largely ignorant about fundamental aspects of its general biology, life cycle, and population dynamics. Here, we report the karyotype variability of 26 C. auris strains representing the four main clades. We demonstrate that all strains are haploid and have a highly plastic karyotype containing five to seven chromosomes, which can undergo marked alterations within a short time frame when the fungus is put under genotoxic, heat, or osmotic stress. No simple correlation was found between karyotype pattern, drug resistance, and clade affiliation indicating that karyotype heterogeneity is rapidly evolving. As with other Candida species, these marked karyotype differences between isolates are likely to have an important impact on pathogenic traits of C. auris.
Schelenz S, Hagen F, Rhodes JL, et al., 2016, First hospital outbreak of the globally emerging Candida auris in a European hospital, Antimicrobial Resistance and Infection Control, Vol: 5, ISSN: 2047-2994
Background: Candida auris is a globally emerging multidrug resistant fungal pathogen causing nosocomial transmission.We report an ongoing outbreak of C. auris in a London cardio-thoracic center between April 2015 and July 2016. This isthe first report of C. auris in Europe and the largest outbreak so far. We describe the identification, investigation andimplementation of control measures.Methods: Data on C. auris case demographics, environmental screening, implementation of infection prevention/controlmeasures, and antifungal susceptibility of patient isolates were prospectively recorded then analysed retrospectively.Speciation of C. auris was performed by MALDI-TOF and typing of outbreak isolates performed by amplified fragmentlength polymorphism (AFLP).Results: This report describes an ongoing outbreak of 50 C. auris cases over the first 16 month (April 2015 to July 2016)within a single Hospital Trust in London. A total of 44 % (n = 22/50) patients developed possible or proven C. aurisinfection with a candidaemia rate of 18 % (n = 9/50). Environmental sampling showed persistent presence of the yeastaround bed space areas. Implementation of strict infection and prevention control measures included: isolationof cases and their contacts, wearing of personal protective clothing by health care workers, screening ofpatients on affected wards, skin decontamination with chlorhexidine, environmental cleaning with chorinebased reagents and hydrogen peroxide vapour. Genotyping with AFLP demonstrated that C. auris isolates fromthe same geographic region clustered.Conclusion: This ongoing outbreak with genotypically closely related C. auris highlights the importance ofappropriate species identification and rapid detection of cases in order to contain hospital acquired transmission.
Schelenz S, Bidula S, 2016, A sweet response to a sour situation: the role of soluble pattern recognition receptors in the Innate immune response to invasive Aspergillus fumigatus infections, Plos Pathogens, Vol: 12, ISSN: 1553-7374
Lund-Palau H, Turnbull AR, Bush A, et al., 2016, Pseudomonas aeruginosa infection in cystic fibrosis: pathophysiological mechanisms and therapeutic approaches, Expert Review of Respiratory Medicine, Vol: 10, Pages: 685-697, ISSN: 1747-6348
Pseudomonas aeruginosa is a remarkably versatile environmental bacterium with an extraordinary capacity to infect the cystic fibrosis (CF) lung. Infection with P. aeruginosa occurs early, and although eradication can be achieved following early detection, chronic infection occurs in over 60% of adults with CF. Chronic infection is associated with accelerated disease progression and increased mortality. Extensive research has revealed complex mechanisms by which P. aeruginosa adapts to and persists within the CF airway. Yet knowledge gaps remain, and prevention and treatment strategies are limited by the lack of sensitive detection methods and by a narrow armoury of antibiotics. Further developments in this field are urgently needed in order to improve morbidity and mortality in people with CF. Here, we summarize current knowledge of pathophysiological mechanisms underlying P. aeruginosa infection in CF. Established treatments are discussed, and an overview is offered of novel detection methods and therapeutic strategies in development.
Khoo V, Pabary R, Palau HL, et al., 2015, VARIABILITY IN SUSCEPTIBILITY TO ANTIBIOTICS AND BACTERIOPHAGES BETWEEN INDIVIDUAL COLONIES OF PSEUDOMONAS AERUGINOSA FROM CYSTIC FIBROSIS SPUTUM SAMPLES: IMPLICATIONS FOR FUTURE CLINICAL TRIAL DESIGN, Winter Meeting of the British-Thoracic-Society, Publisher: BMJ PUBLISHING GROUP, Pages: A64-A65, ISSN: 0040-6376
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- Citations: 1
Schelenz S, 2015, Serum opsonin ficolin-A enhances host–fungal interactionsand modulates cytokine expression from humanmonocyte-derived macrophages and neutrophilsfollowing Aspergillus fumigatus challenge, Med Microbiol Immunol
Bidula S, Sexton DW, Abdolrasouli A, et al., 2015, The Serum Opsonin L-ficolin Is Detected in Lungs of Human Transplant Recipients Following Fungal Infections and Modulates Inflammation and Killing of Aspergillus fumigatus, JOURNAL OF INFECTIOUS DISEASES, Vol: 212, Pages: 234-246, ISSN: 0022-1899
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- Citations: 32
Bidula S, Sexton DW, Yates M, et al., 2015, H-ficolin binds Aspergillus fumigatus leading to activation of the lectin complement pathway and modulation of lung epithelial immune responses., Immunology, Vol: 146, Pages: 281-291, ISSN: 1365-2567
Aspergillus fumigatus is an opportunistic fungal pathogen that typically infects the lungs of immunocompromised patients leading to a high mortality. H-ficolin, an innate immune opsonin, is produced by type II alveolar epithelial cells and could participate in lung defences against infections. Here, we utilised the human type II alveolar epithelial cell line, A549, to determine the involvement of H-ficolin in fungal defence. Additionally, we investigated the presence of H-ficolin in bronchoalveolar lavage fluid (BAL) from transplant patients during pneumonia. H-ficolin exhibited demonstrable binding to A. fumigatus conidia via L-fucose, D-mannose and N-acetylglucosamine residues in a calcium- and pH-dependent manner. Moreover, recognition led to lectin complement pathway activation and enhanced fungal association with A549 cells. Following recognition, H-ficolin opsonization manifested an increase in IL-8 production from A549 cells which involved activation of the intracellular signalling pathways MEK 1/2, p38 MAPK and JNK. Finally, H-ficolin concentrations were significantly higher in BAL of patients with lung infections compared to control subjects (n=16; p=0.00726). ROC curve analysis further highlighted the potential of H-ficolin as a diagnostic marker for lung infection (AUC=0.77; p<0.0001). Thus, H-ficolin participates in A. fumigatus defence via activation of the lectin complement pathway, enhanced fungal-host interactions and modulated immune responses. This article is protected by copyright. All rights reserved.
Schelenz S, Barnes RA, Barton RC, et al., 2015, British Society for Medical Mycology best practice recommendations for the diagnosis of serious fungal diseases, LANCET INFECTIOUS DISEASES, Vol: 15, Pages: 461-474, ISSN: 1473-3099
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- Citations: 118
Schelenz S, 2014, Luke Moore and Silke Schelenz: Candida Infection in the Intensive Care Unit, Challenging Concepts in Infectious Diseases and Clinical Microbiology, Editors: Griffin, Publisher: Oxford University Press (UK), ISBN: 9780199665754
As the reader works through each case there are 'Clinical Tips', 'Learning Points' and 'Evidence Base' boxes to enhance the learning process along with the 'Expert Commentary', providing an inside track on how the experts approach ...
Schelenz S, Nwaka D, Hunter PR, 2013, Longitudinal surveillance of bacteraemia in haematology and oncology patients at a UK cancer centre and the impact of ciprofloxacin use on antimicrobial resistance, JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY, Vol: 68, Pages: 1431-1438, ISSN: 0305-7453
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- Citations: 47
Bidula S, Kenawy H, Ali YM, et al., 2013, Role of Ficolin-A and Lectin Complement Pathway in the Innate Defense against Pathogenic Aspergillus Species, INFECTION AND IMMUNITY, Vol: 81, Pages: 1730-1740, ISSN: 0019-9567
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- Citations: 26
Gooday C, Hallam C, Sieber C, et al., 2013, An antibiotic formulary for a tertiary care foot clinic: admission avoidance using intramuscular antibiotics for borderline foot infections in people with diabetes, DIABETIC MEDICINE, Vol: 30, Pages: 581-589, ISSN: 0742-3071
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- Citations: 8
Erskine SE, Schelenz S, Philpott CM, 2013, Unilateral cacosmia: a presentation of maxillary fungal infestation., BMJ Case Rep, Vol: 2013
We present a case of long-standing unilateral cacosmia in a healthy 67-year-old man due to maxillary fungal infestation. Treatment with septoplasty had been attempted 10 years prior but no further investigation or management undertaken and symptoms continued. Subsequent MRI scan revealed significant opacification of the left maxillary sinus. This was readily amenable to treatment by balloon sinuplasty. This yielded viscous grey mucus which grew Scedosporium apiospermum. The case highlights the need for careful investigation of olfactory symptoms, including blood tests to exclude systemic causes, endoscopy and imaging where indicated.
Schelenz S, Kirchhof N, Bidula S, et al., 2013, Opsonizing properties of rat ficolin-A in the defence against Cryptococcus neoformans, IMMUNOBIOLOGY, Vol: 218, Pages: 477-483, ISSN: 0171-2985
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- Citations: 10
Schelenz S, Giles D, Abdallah S, 2012, Epidemiology, management and economic impact of febrile neutropenia in oncology patients receiving routine care at a regional UK cancer centre, ANNALS OF ONCOLOGY, Vol: 23, Pages: 1889-1893, ISSN: 0923-7534
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- Citations: 32
Steverding D, Evans P, Msika L, et al., 2012, In vitro antifungal activity of DNA topoisomerase inhibitors, MEDICAL MYCOLOGY, Vol: 50, Pages: 333-336, ISSN: 1369-3786
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- Citations: 11
Schelenz S, Tong CYW, 2011, Clinical virology in NICU, PICU and AICU, Infection Control in the Intensive Care Unit, Editors: Van Saene, Publisher: Springer Science & Business Media, ISBN: 9788847016002
This edition condenses and updates the information of the previous edition, with the addition of new tables and figures, and contains two completely new chapters on microcirculation and mechanisms of action behind the efficacy of Selective ...
Schelenz S, Abdallah S, Gray G, et al., 2011, Epidemiology of oral yeast colonization and infection in patients with hematological malignancies, head neck and solid tumors, JOURNAL OF ORAL PATHOLOGY & MEDICINE, Vol: 40, Pages: 83-89, ISSN: 0904-2512
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- Citations: 60
Hill-Cawthorne GA, Schelenz S, Lawes M, et al., 2010, Oseltamivir-resistant pandemic (H1N1) 2009 in patient with impaired immune system., Emerging Infectious Diseases, Vol: 16, Pages: 1185-1186, ISSN: 1080-6059
Kwok SC, Schelenz S, Wang X, et al., 2010, In vitro effect of DNA topoisornerase inhibitors on Candida albicans, MEDICAL MYCOLOGY, Vol: 48, Pages: 155-160, ISSN: 1369-3786
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- Citations: 14
Sajjad Raja N, Schelenz S, 2010, Cyclospora cayetanensis causing diarrhoea in adults in Norfolk, England: Report of two cases and review of literature, Scottish Medical Journal, Vol: 55, ISSN: 0036-9330
Cyclospora cayetanensis is an important emerging infectious disease agent found worldwide causing cyclosporiasis; a condition presenting with prolonged and profuse diarrhoea in immunocompetent and immunocompromised (such as AIDS) patients. It is endemic in some tropical regions of the world and mostly associated with travel to these areas. The prevalence of Cyclospora cayetanensis in the UK remains very low. Cases of cyclosporiasis are often misdiagnosed or even missed due to the lack of understanding of the epidemiological and laboratory features of this pathogen. In this report a 42 year old male animal farm worker and a 45 year old female patient presented with the signs and symptoms of a gastrointestinal illness over a period of several weeks. Cyclospora cayetanensis oocysts were detected in stool specimens. Oral Trimethoprim-sulfamethaxazole 160/800 mg twice daily for 10 days was administered in first patient while second patient improved without specific treatment. This is a first example of a possible link between animals to human spread of Cyclospora cayetanensis in one of the cases. The authors also review the previously reported cyclosporiasis cases in the literature. © 2010, Scottish Medical Journal. All rights reserved.
Schelenz S, Barnes RA, Kibbler CC, et al., 2009, Standards of care for patients with invasive fungal infections within the United Kingdom: A national audit, JOURNAL OF INFECTION, Vol: 58, Pages: 145-153, ISSN: 0163-4453
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- Citations: 32
Vivancos R, Schelenz S, Loke YK, 2007, Internet treatment of sexually transmitted infections - a public health hazard?, BMC Public Health, Vol: 7, ISSN: 1471-2458
BACKGROUND: Owing to the stigma associated with sexually transmitted infections, patients may prefer to keep their illness private, and choose instead to try self-treatment remedies from the internet. However, such remedies may prove hazardous if the sellers do not provide detailed advice on adverse effects, or on avoiding transmission and re-infection. We conducted an internet search to determine the availability of treatments for STIs and the nature of information provided by vendors of these treatments. METHODS: We conducted a systematic internet search using five different search engines in February 2007. The search term included the words "self treatment" and the name of six different common STIs. We visited the vendors' websites and recorded any information on the formulation, adverse effects, cautions, and prevention of infection. RESULTS: We identified a total of 77 treatments from 52 different companies, most of which were sold from the UK and US. The available remedies were predominantly for topical use and consisted mainly of homeopathic remedies. Only a small proportion of the web-listed products gave details on adverse effects, contraindications and interactions (22%, 25% and 9% respectively). Similarly, web vendors seldom provided advice on treatment of sexual contacts (20% of chlamydia and 25% of gonorrhea treatments) or on preventive measures (13%). Conversely, evidence of effectiveness was claimed for approximately 50% of the products. CONCLUSION: While treatments for certain STIs are widely available on the internet, purchasers of such products may potentially suffer harm because of the lack of information on adverse effects, interactions and contra-indications. Moreover, we consider the paucity of preventive health advice to be a serious omission, thereby leading to patients being needlessly exposed to, and potentially re-infected with the causative pathogens.
Abubakar I, Irvine L, Aldus CM, et al., 2007, A systematic review of the clinical, public health and cost-effectiveness of rapid diagnostic tests for the detection and identification of bacterial intestinal pathogens in faeces and food, HEALTH TECHNOLOGY ASSESSMENT, Vol: 11, Pages: 1-+, ISSN: 1366-5278
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- Citations: 84
Abubakar I, Irvine L, Aldus CF, et al., 2007, A systematic review of the clinical, public health and cost-effectiveness of rapid diagnostic tests for the detection and identification of bacterial intestinal pathogens in faeces and food, Health Technology Assessment, Vol: 11, ISSN: 1366-5278
Objectives: To determine the diagnostic accuracy of tests for the rapid diagnosis of bacterial food poisoning in clinical and public health practice and to estimate the cost-effectiveness of these assays in a hypothetical population in order to inform policy on the use of these tests. Data sources: Studies evaluating diagnostic accuracy of rapid tests were retrieved using electronic databases and handsearching reference lists and key journals. Hospital laboratories and test manufacturers were contacted for cost data, and clinicians involved in the care of patients with food poisoning were invited to discuss the conclusions of this review using the nominal group technique. Review methods: A systematic review of the current medical literature on assays used for the rapid diagnosis of bacterial food poisoning was carried out. Specific organisms under review were Salmonella, Campylobacter, Escherichia coli O157, Staphylococcus aureus, Clostridium perfringens and Bacillus cereus. Data extraction was undertaken using standardised data extraction forms. Where a sufficient number of studies evaluating comparable tests were identified, meta-analysis was performed. A decision analytic model was developed, using effectiveness data from the review and cost data from hospitals and manufacturers, which contributed to an assessment of the cost-effectiveness of rapid tests in a hypothetical UK population. Finally, diagnostic accuracy and cost-effectiveness results were presented to a focus group of GPs, microbiologists and consultants in communicable disease control, to assess professional opinion on the use of rapid tests in the diagnosis of food poisoning. Results: Good test performance levels were observed with rapid test methods, especially for polymerase chain reaction (PCR) assays. The estimated levels of diagnostic accuracy using the area under the curve of the summary receiver operating characteristic curve was very high. Indeed, although traditional culture is the natural
Schelenz S, Bramham K, Goldsmith D, 2007, Septic arthritis due to extended spectrum beta lactamase producing Klebsiella pneumoniae, JOINT BONE SPINE, Vol: 74, Pages: 275-278, ISSN: 1297-319X
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- Citations: 16
Schelenz S, Bramham K, Goldsmith D, 2007, Septic arthritis due to extended spectrum beta lactamase producing Klebsiella pneumoniae<sup>{lozenge, open}</sup>{lozenge, open}Pour citer cet article, utiliser ce titre en anglais et sa référence dans le même volume de Joint Bone Spine., Revue du Rhumatisme (Edition Francaise), Vol: 74, Pages: 491-495, ISSN: 1169-8330
Schelenz S, 2007, Management of candidiasis in the intensive care unit, JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY, Vol: 61, Pages: I31-I34, ISSN: 0305-7453
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- Citations: 47
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