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Monstein, Hans-Jürg
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Publications (10 of 56) Show all publications
Gustavsson, O., Johansson, A. V., Monstein, H.-J., Nilsson, L. E. & Bredberg, A. (2016). A wide spectrum of fastidious and ampicillin-susceptible bacteria dominate in animal-caused wounds. European Journal of Clinical Microbiology and Infectious Diseases, 35(8), 1315-1321
Open this publication in new window or tab >>A wide spectrum of fastidious and ampicillin-susceptible bacteria dominate in animal-caused wounds
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2016 (English)In: European Journal of Clinical Microbiology and Infectious Diseases, ISSN 0934-9723, E-ISSN 1435-4373, Vol. 35, no 8, p. 1315-1321Article in journal (Refereed) Published
Abstract [en]

The main purpose of this study was to assess the actual occurrence of Gram-negative oxidase-positive bacteria (GNOP) in human wounds caused by animals, mostly cat and dog bites and scratches, and with signs of infection. We report a prospective series of 92 wound samples. Routine culturing was combined with a procedure optimised for fastidious GNOP. All GNOP isolates were identified by 16S rDNA sequencing to the species level. We observed a more prominent role of GNOP, including at least 30 species mostly in the families Flavobacteriaceae, Neisseriaceae and Pasteurellaceae, and less of Staphylococcus aureus and streptococci. The antibiotic susceptibility pattern was investigated, as GNOP are associated with sudden onset of serious infections, making an early decision on antibiotic treatment vital. All GNOP isolates judged to be clinically relevant displayed susceptibility to ampicillin and meropenem, but resistance to oxacillin, clindamycin and gentamicin was frequent. Our findings emphasise the need to cover GNOP as recommended in guidelines, and not only common wound pathogens, when treating an animal-caused wound.

Place, publisher, year, edition, pages
SPRINGER, 2016
National Category
Infectious Medicine
Identifiers
urn:nbn:se:liu:diva-130832 (URN)10.1007/s10096-016-2667-z (DOI)000380089800012 ()27197725 (PubMedID)
Note

Funding Agencies|Clinical Microbiology, University Hospital, Linkoping, Sweden

Available from: 2016-08-26 Created: 2016-08-26 Last updated: 2018-03-19
Monstein, H.-J., Tärnberg, M., Persis, S. & Johansson, A. G. (2014). Comparison of a capillary gel electrophoresis-based multiplex PCR assay and ribosomal intergenic transcribed spacer-2 amplicon sequencing for identification of clinically important Candida species. Journal of Microbiological Methods, 96, 81-83
Open this publication in new window or tab >>Comparison of a capillary gel electrophoresis-based multiplex PCR assay and ribosomal intergenic transcribed spacer-2 amplicon sequencing for identification of clinically important Candida species
2014 (English)In: Journal of Microbiological Methods, ISSN 0167-7012, E-ISSN 1872-8359, Vol. 96, p. 81-83Article in journal (Refereed) Published
Abstract [en]

The performance of a commercially available Seegene Seeplex STI Master Panel 3 multiplex PCR for Candida species identification was compared with an internal transcribed spacer 2 (ITS2) PCR assay. We found that the Seeplex assay was specific for identification of C. albicans, C. krusei, C. parapsilosis, C. glabrata, C. tropicalis and C. dubliniensis.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-102441 (URN)10.1016/j.mimet.2013.11.004 (DOI)000329771000015 ()24252582 (PubMedID)
Available from: 2014-01-10 Created: 2013-12-10 Last updated: 2017-12-06
Östholm Balkhed, Å., Tärnberg, M., Monstein, H.-J., Hällgren, A., Hanberger, H. & Nilsson, L. E. (2013). High frequency of co-resistance in CTX-M-producing Escherichia coli to non-beta-lactam antibiotics, with the exception of amikacin, nitrofurantoin, colistin, tigecycline, and fosfomycin, in a county of Sweden. Scandinavian Journal of Infectious Diseases, 45(4), 271-278
Open this publication in new window or tab >>High frequency of co-resistance in CTX-M-producing Escherichia coli to non-beta-lactam antibiotics, with the exception of amikacin, nitrofurantoin, colistin, tigecycline, and fosfomycin, in a county of Sweden
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2013 (English)In: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 45, no 4, p. 271-278Article in journal (Refereed) Published
Abstract [en]

Background: The objective of this study was to investigate the in vitro activity of different antibiotics against CTX-M-producing Escherichia coli in a county of Sweden, and to determine the occurrence of multi-resistance and plasmid- mediated quinolone resistance among these isolates. Methods: A total of 198 isolates of E. coli with extended-spectrum beta-lactamase (ESBL) phenotype and mainly CTX-M genotype were studied. The minimum inhibitory concentrations (MICs) for amikacin, chloramphenicol, ciprofloxacin, colistin, fosfomycin, gentamicin, nalidixic acid, nitrofurantoin, tigecycline, tobramycin, trimethoprim, and trimethoprim-sulfamethoxazole were determined with the Etest. Susceptibility was defined according to the breakpoints of the European Committee on Antimicrobial Susceptibility Testing (EUCAST). MIC(50) and MIC(90) values were calculated. Results: Ninety-five percent or more of the isolates were susceptible to amikacin, nitrofurantoin, colistin, tigecycline, and fosfomycin. CTX-M group 9 was more susceptible than CTX-M group 1 to ciprofloxacin, gentamicin, and tobramycin. Sixty-eight percent of the isolates were multi-resistant, and the most common multi-resistance pattern was ESBL phenotype with decreased susceptibility to trimethoprim, trimethoprim-sulfamethoxazole, ciprofloxacin, gentamicin, and tobramycin. Only 1 isolate carried a qnrS1 gene, but 37% carried aac(6')-Ib-cr. Conclusions: A high frequency of co-resistance between ESBL-producing E. coli and non-beta-lactam antibiotics was seen. On the other hand, very high susceptibility was seen for amikacin, nitrofurantoin, colistin, tigecycline, and fosfomycin. These data support the replacement of gentamicin and tobramycin, normally used in Sweden, with amikacin, for severe infections.

Keywords
Etest, minimum inhibitory concentration, extended-spectrum beta-lactamase
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-87612 (URN)10.3109/00365548.2012.734636 (DOI)000316693600005 ()23113731 (PubMedID)
Available from: 2013-01-19 Created: 2013-01-19 Last updated: 2017-12-06
Monstein, H.-J., Ryberg, A. & Karlsson, A. (2012). Assessment of the mosaic structure in the Helicobacter pylori cagA gene 3 -region using an improved polymerase chain reaction-based assay. Diagnostic microbiology and infectious disease, 73(3), 281-283
Open this publication in new window or tab >>Assessment of the mosaic structure in the Helicobacter pylori cagA gene 3 -region using an improved polymerase chain reaction-based assay
2012 (English)In: Diagnostic microbiology and infectious disease, ISSN 0732-8893, E-ISSN 1879-0070, Vol. 73, no 3, p. 281-283Article in journal (Refereed) Published
Abstract [en]

The mosaic structure of the cagA gene has been suggested to affect Helicobacter pylori CagA-associated pathogenesis. An improved polymerase chain reaction assay allowed for a rapid and detailed molecular analysis of the cagA gene 3-region in a single amplification step, followed by amplicon sequencing using universal M13 and T7 sequencing primers.

Place, publisher, year, edition, pages
Elsevier, 2012
Keywords
Molecular genotyping; Amplicon sequencing; cagA EPIYA/T segment; cagA pre-EPIYA/T region; CagA multimerisation motif
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-79684 (URN)10.1016/j.diagmicrobio.2012.03.017 (DOI)000305546300018 ()
Available from: 2012-08-14 Created: 2012-08-13 Last updated: 2017-12-07
Karlsson, A., Ryberg, A., Dehnoei, M. N., Borch, K. & Monstein, H.-J. (2012). Association between cagA and vacA genotypes and pathogenesis in a Helicobacter pylori infected population from South-eastern Sweden. BMC Microbiology, 12(129)
Open this publication in new window or tab >>Association between cagA and vacA genotypes and pathogenesis in a Helicobacter pylori infected population from South-eastern Sweden
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2012 (English)In: BMC Microbiology, ISSN 1471-2180, E-ISSN 1471-2180, Vol. 12, no 129Article in journal (Refereed) Published
Abstract [en]

UNLABELLED: ABSTRACT:

BACKGROUND: Chronic gastritis, peptic ulcer disease, and gastric cancer have been shown to be related to infection with Helicobacter pylori (H. pylori). Two major virulence factors of H. pylori, CagA and VacA, have been associated with these sequelae of the infection. In this study, total DNA was isolated from gastric biopsy specimens to assess the cagA and vacA genotypes.

RESULTS: Variations in H. pylori cagA EPIYA motifs and the mosaic structure of vacA s/m/i/d regions were analysed in 155 H. pylori-positive gastric biopsies from 71 individuals using PCR and sequencing. Analysis of a possible association between cagA and vacA genotypes and gastroduodenal pathogenesis was made by logistic regression analysis. We found that H. pylori strains with variation in the number of cagA EPIYA motif variants present in the same biopsy correlated with peptic ulcer, while occurrence of two or more EPIYA-C motifs was associated with atrophy in the gastric mucosa. No statistically significant relation between vacA genotypes and gastroduodenal pathogenesis was observed.

CONCLUSIONS: The results of this study indicate that cagA genotypes may be important determinants in the development of gastroduodenal sequelae of H. pylori infection. In contrast to other studies, vacA genotypes were not related to disease progression or outcome. In order to fully understand the relations between cagA, vacA and gastroduodenal pathogenesis, the mechanisms by which CagA and VacA act and interact need to be further investigated.

Place, publisher, year, edition, pages
BioMed Central, 2012
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-86666 (URN)10.1186/1471-2180-12-129 (DOI)000312189100001 ()22747681 (PubMedID)
Available from: 2013-01-14 Created: 2012-12-20 Last updated: 2017-12-06Bibliographically approved
Karlsson, A., Ryberg, A., Nosouhi Dehnoei, M., Borch, K. & Monstein, H.-J. (2012). Variation in number of cagA EPIYA-C phosphorylation motifs between cultured Helicobacter pylori and biopsy strain DNA. Infection, Genetics and Evolution, 12(1), 175-179
Open this publication in new window or tab >>Variation in number of cagA EPIYA-C phosphorylation motifs between cultured Helicobacter pylori and biopsy strain DNA
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2012 (English)In: Infection, Genetics and Evolution, ISSN 1567-1348, E-ISSN 1567-7257, Vol. 12, no 1, p. 175-179Article in journal (Refereed) Published
Abstract [en]

The Helicobacter pylori cagA gene encodes a cytotoxin which is activated by phosphorylation after entering the host epithelial cell. Phosphorylation occurs on specific tyrosine residues within EPIYA motifs in the variable 3'-region. Four different cagA EPIYA motifs have been defined according to the surrounding amino acid sequence; EPIYA-A, -B, -C and -D. Commonly, EPIYA-A and -B are followed by one or more EPIYA-C or -D motif. Due to observed discrepancies in cagA genotypes in cultured H. pylori and the corresponding DNA extracts it has been suggested that genotyping assays preferentially should be performed directly on DNA isolated from biopsy specimens. Gastric biopsies randomly selected from a Swedish cohort were homogenised and used for both direct DNA isolation and for H. pylori specific culturing and subsequent DNA isolation. In 123 of 153 biopsy specimens, the cagA EPIYA genotypes were in agreement with the corresponding cultured H. pylori strains. A higher proportion of mixed cagA EPIYA genotypes were found in the remaining 30 biopsy specimens. Cloning and sequencing of selected cagA EPIYA amplicons revealed variations in number of cagA EPIYA-C motifs in the mixed amplicons. The study demonstrates that culturing of H. pylori introduces a bias in the number of EPIYA-C motif. Consistent with other H. pylori virulence genotyping studies, we suggest that cagA EPIYA analysis should be performed using total DNA isolated from biopsy specimens.

Place, publisher, year, edition, pages
Elsevier, 2012
Keywords
Gastroduodenal diseases; Helicobacter pylori; cagA EPIYA-C motif variation; Gastric biopsy H. pylori strains; Cultured H. pylori strains; Amplicon sequencing
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-72456 (URN)10.1016/j.meegid.2011.10.025 (DOI)000299599600022 ()22085823 (PubMedID)
Note
funding agencies|Research council in the South-East of Sweden (FORSS)||ALF||Clinical Microbiology, Laboratory Centre-DC, University Hospital, Linkoping, Sweden||Available from: 2011-11-28 Created: 2011-11-28 Last updated: 2017-12-08
Ryberg, A., Olsson, C., Ahrné, S. & Monstein, H.-J. (2011). Comparison of (GTG)5-oligonucleotide and ribosomal intergenic transcribed spacer (ITS)-PCR for molecular typing of Klebsiella isolates. Journal of Microbiological Methods, 84(2), 183-188
Open this publication in new window or tab >>Comparison of (GTG)5-oligonucleotide and ribosomal intergenic transcribed spacer (ITS)-PCR for molecular typing of Klebsiella isolates
2011 (English)In: Journal of Microbiological Methods, ISSN 0167-7012, E-ISSN 1872-8359, Vol. 84, no 2, p. 183-188Article in journal (Refereed) Published
Abstract [en]

Molecular typing of Klebsiella species has become important for monitoring dissemination of β-lactamase-producers in hospital environments. The present study was designed to evaluate poly-trinucleotide (GTG)5- and rDNA intergenic transcribed spacer (ITS)-PCR fingerprint analysis for typing of Klebsiella pneumoniae and Klebsiella oxytoca isolates. Multiple displacement amplified DNA derived from 19 K. pneumoniae (some with an ESBL-phenotype), 35 K. oxytoca isolates, five K. pneumoniae, two K. oxytoca, three Raoultella, and one Enterobacter aerogenes type and reference strains underwent (GTG)5 and ITS-PCR analysis. Dendrograms were constructed using cosine coefficient and the Neighbour joining method. (GTG)5 and ITS-PCR analysis revealed that K. pneumoniae and K. oxytoca isolates, reference and type strains formed distinct cluster groups, and tentative subclusters could be established. We conclude that (GTG)5 and ITS-PCR analysis combined with automated capillary electrophoresis provides promising tools for molecular typing of Klebsiella isolates.

Place, publisher, year, edition, pages
Elsevier, 2011
Keywords
Klebsiella spp.; Molecular typing; (GTG)5-PCR; Ribosomal intergenic transcribed spacer (ITS)-PCR; Fingerprint analysis; Multiple displacement amplification
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-65401 (URN)10.1016/j.mimet.2010.11.019 (DOI)000287951200005 ()
Note
Original Publication: Anna Ryberg, Crister Olsson, Siv Ahrné and Hans-Jürg Monstein, Comparison of (GTG)5-oligonucleotide and ribosomal intergenic transcribed spacer (ITS)-PCR for molecular typing of Klebsiella isolates, 2011, Journal of Microbiological Methods, (84), 2, 183-188. http://dx.doi.org/10.1016/j.mimet.2010.11.019 Copyright: Elsevier Science B.V., Amsterdam. http://www.elsevier.com/Available from: 2011-02-07 Created: 2011-02-07 Last updated: 2017-12-11
Ryberg, A., Borch, K. & Monstein, H.-J. (2011). Expression of multiple forms of 3'-end variant CCK2 receptor mRNAs in human pancreatic adenocarcinoma. BMC research notes, 4, 131
Open this publication in new window or tab >>Expression of multiple forms of 3'-end variant CCK2 receptor mRNAs in human pancreatic adenocarcinoma
2011 (English)In: BMC research notes, ISSN 1756-0500, Vol. 4, p. 131-Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Two main types of receptors for gastrin and cholecystokinin (CCK) have been cloned and identified. CCK1 (CCK-A) receptors are expressed in the pancreas, the gallbladder, and parts of the brain, while CCK2 (CCK-B/gastrin) receptors (CCK2R) are expressed in gastric glands and in most of the brain. A splice variant of the CCK2R designated CCKRi4sv (CCK-C), which is constitutively expressed in human pancreatic cancer cells, has also been described. The purpose of the present investigation was to study CCK2R, CCK2i4svR, and gastrin mRNA expression in human pancreatic adenocarcinoma on the assumption that co-expression of CCK2R and gastrin or constitutive CCK2i4svR mRNA expression plays a pivotal role in the progression of pancreatic cancer.

FINDINGS: PCR amplification using CCK2R specific primer-pairs, followed by ethidium-bromide stained agarose gel electrophoresis revealed the expression of wild-type CCK2R mRNA in 12 of 17 biopsy specimens. A CCK2R intron 4 specific nested PCR assay revealed that CCK2i4svR mRNA was expressed in only one of the biopsy specimen. The authenticity of PCR amplicons was confirmed by cloning of selected amplicons and DNA sequence analysis. Moreover, we found that hitherto undescribed multiple forms of 3'-end variant CCK2R mRNAs with various deletions in the retained intron 4 and exon 5, tentatively generating truncated proteins, were expressed in the pancreatic adenocarcinomas.

CONCLUSION: Cloning and DNA sequencing of selected amplicons revealed that CCK2R and multiple CCK2i4svR-like mRNAs are expressed in human pancreatic adenocarcinoma. The originally described CCK2i4svR mRNA was only expressed in one of 17 tumours and appears to be rarely expressed in pancreatic adenocarcinoma. We report that CCK2R- and gastrin mRNA co-expression may play a role in a portion, but not in all of these tumours, and that aberrant splicing takes places in these tissues generating multiple forms of 3'-end variant CCK2R mRNAs.

Place, publisher, year, edition, pages
BMC, 2011
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-71398 (URN)10.1186/1756-0500-4-131 (DOI)21504585 (PubMedID)
Available from: 2011-10-14 Created: 2011-10-14 Last updated: 2012-03-23
Woksepp, H., Jernberg, C., Tärnberg, M., Ryberg, A., Brolund, A., Nordvall, M., . . . Schön, T. (2011). High-Resolution Melting-Curve Analysis of Ligation-Mediated Real-Time PCR for Rapid Evaluation of an Epidemiological Outbreak of Extended-Spectrum-Beta-Lactamase-Producing Escherichia coli. Journal of Clinical Microbiology, 49(12), 4032-4039
Open this publication in new window or tab >>High-Resolution Melting-Curve Analysis of Ligation-Mediated Real-Time PCR for Rapid Evaluation of an Epidemiological Outbreak of Extended-Spectrum-Beta-Lactamase-Producing Escherichia coli
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2011 (English)In: Journal of Clinical Microbiology, ISSN 0095-1137, E-ISSN 1098-660X, Vol. 49, no 12, p. 4032-4039Article in journal (Refereed) Published
Abstract [en]

Methods for the confirmation of nosocomial outbreaks of bacterial pathogens are complex, expensive, and time-consuming. Recently, a method based on ligation-mediated PCR (LM/PCR) using a low denaturation temperature which produces specific melting-profile patterns of DNA products has been described. Our objective was to further develop this method for real-time PCR and high-resolution melting analysis (HRM) in a single-tube system optimized in order to achieve results within 1 day. Following the optimization of LM/PCR for real-time PCR and HRM (LM/HRM), the method was applied for a nosocomial outbreak of extended-spectrum-beta-lactamase (ESBL)-producing and ST131-associated Escherichia coli isolates (n = 15) and control isolates (n = 29), including four previous clusters. The results from LM/HRM were compared to results from pulsed-field gel electrophoresis (PFGE), which served as the gold standard. All isolates from the nosocomial outbreak clustered by LM/HRM, which was confirmed by gel electrophoresis of the LM/PCR products and PFGE. Control isolates that clustered by LM/PCR (n = 4) but not by PFGE were resolved by confirmatory gel electrophoresis. We conclude that LM/HRM is a rapid method for the detection of nosocomial outbreaks of bacterial infections caused by ESBL-producing E. coli strains. It allows the analysis of isolates in a single-tube system within a day, and the discriminatory power is comparable to that of PFGE.

Place, publisher, year, edition, pages
American Society for Microbiology, 2011
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-74435 (URN)10.1128/JCM.01042-11 (DOI)000298113400002 ()
Note

Funding Agencies|Kalmar County Hospital||FORSS (The Research Council of Southeast Sweden)||

Available from: 2012-01-27 Created: 2012-01-27 Last updated: 2017-12-08
Tärnberg, M., Östholm Balkhed, Å., Monstein, H.-J., Hällgren, A., Hanberger, H. & Nilsson, L. E. (2011). In vitro activity of beta-lactam antibiotics against CTX-M-producing Escherichia coli. European Journal of Clinical Microbiology and Infectious Diseases, 30(8), 981-987
Open this publication in new window or tab >>In vitro activity of beta-lactam antibiotics against CTX-M-producing Escherichia coli
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2011 (English)In: European Journal of Clinical Microbiology and Infectious Diseases, ISSN 0934-9723, E-ISSN 1435-4373, Vol. 30, no 8, p. 981-987Article in journal (Refereed) Published
Abstract [en]

Beta-lactam antibiotics have been discussed as options for the treatment of infections caused by multiresistant extended-spectrum beta-lactamase (ESBL)-producing bacteria if the minimum inhibitory concentration (MIC) is low. The objective of this study was to investigate the in vitro activity of different beta-lactam antibiotics against CTX-M-producing Escherichia coli. A total of 198 isolates of E. coli with the ESBL phenotype were studied. Polymerase chain reaction (PCR) amplification of CTX-M genes and amplicon sequencing were performed. The MICs for amoxicillin-clavulanic acid, aztreonam, cefepime, cefotaxime, ceftazidime, ceftibuten, ertapenem, imipenem, mecillinam, meropenem, piperacillin-tazobactam, and temocillin were determined with the Etest. Susceptibility was defined according to the breakpoints of the European Committee on Antimicrobial Susceptibility Testing (EUCAST). MIC(50) and MIC(90) values were calculated. Isolates from CTX-M group 9 showed higher susceptibility to the beta-lactam antibiotics tested than isolates belonging to CTX-M group 1. More than 90% of the isolates belonging to CTX-M group 9 were susceptible to amoxicillin-clavulanic acid, ceftazidime, ceftibuten, piperacillin-tazobactam, and temocillin. The susceptibility was high to mecillinam, being 91%, regardless of the CTX-M group. All isolates were susceptible to imipenem and meropenem, and 99% to ertapenem. This study shows significant differences in susceptibility to different beta-lactam antibiotics among the CTX-M-producing E. coli isolates and a significant difference for many antibiotics tested between the CTX-M-producing groups 1 and 9. The good in vitro activity of other beta-lactam antibiotics compared to carbapenems indicate that clinical studies are warranted in order to examine the potential role of these beta-lactam antibiotics in the treatment of infections caused by multiresistant ESBL-producing E. coli.

Place, publisher, year, edition, pages
Springer Science Business Media, 2011
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-69787 (URN)10.1007/s10096-011-1183-4 (DOI)000292553500008 ()
Available from: 2011-08-10 Created: 2011-08-08 Last updated: 2017-12-08Bibliographically approved
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