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Hannah L Moore, Martine Aabye, Ann Hoban, Bettina Rosner, Stine K Lefevre, Eva Litrup, Luise Müller, Steen Ethelberg, Sandra Simon, Sooria Balasegaram, Lesley Larkin, Cecilia Jernberg, Johanna Takkinen and EU/EEA/UK S. Braenderup Outbreak Investigation Group
Eurosurveillance latest updates, 5.01.2024
Tilføjet 5.01.2024
A genomic cluster of Salmonella Braenderup ST22, a serovar of Salmonella enterica subsp. enterica which causes symptoms of gastrointestinal illness, was notified by Danish authorities to the European Centre for Disease Prevention and Control (ECDC) on 3 May 2021. By 6 July 2021, S. Braenderup outbreak cases (n = 348) had been reported from 12 countries in the European Union/European Economic Area (EU/EEA) and the United Kingdom (UK), including 68 hospitalised cases. With support from affected EU/EEA countries, and in partnership with the European Food Safety Authority (EFSA), ECDC established an international outbreak investigation team to rapidly identify the source and prevent outbreak spread. Consumption information was shared with affected countries through a standard line list, revealing that 124 of 197 cases (63%) reported having eaten (any) melons within 7 days prior to disease onset. The speed and completeness of the investigation, which identified the outbreak vehicle as galia melons imported from Honduras in June 2021, was a direct result of extensive collaboration and information sharing between countries’ national food safety and public health authorities. This article describes the outbreak and the benefits, successes, and challenges of multi-country collaboration for consideration in future large foodborne outbreaks across Europe.
Læs mereTomáš Kliegr, Jiří Jarkovský, Helena Jiřincová, Jaroslav Kuchař, Tomáš Karel, David Chudán, Stanislav Vojíř, Michal Zavřel, Ondřej Šanca and Ruth Tachezy
Eurosurveillance latest updates, 22.09.2023
Tilføjet 22.09.2023
BackgroundThe sensitivity and specificity of selected antigen detection rapid diagnostic tests (AG-RDTs) for SARS-CoV-2 were determined in the unvaccinated population when the Delta variant was circulating. Viral loads, dynamics, symptoms and tissue tropism differ between Omicron and Delta. AimWe aimed to compare AG-RDT sensitivity and specificity in selected subgroups during Omicron vs Delta circulation. MethodsWe retrospectively paired AG-RDT results with PCRs registered in Czechia’s Information System for Infectious Diseases from 1 to 25 December 2021 (Delta, n = 20,121) and 20 January to 24 February 2022 (Omicron, n = 47,104). ResultsWhen confirmatory PCR was conducted on the same day as AG-RDT as a proxy for antigen testing close to peak viral load, the average sensitivity for Delta was 80.4% and for Omicron 81.4% (p
Læs mereMaria Rödenbeck, Olaniyi Ayobami, Tim Eckmanns, Mathias W Pletz, Jutta Bleidorn and Robby Markwart
Eurosurveillance latest updates, 19.05.2023
Tilføjet 19.05.2023
BackgroundAntimicrobial resistance (AMR) is of public health concern worldwide. AimWe aimed to summarise the German AMR situation for clinicians and microbiologists. MethodsWe conducted a systematic review and meta-analysis of 60 published studies and data from the German Antibiotic-Resistance-Surveillance (ARS). Primary outcomes were AMR proportions in bacterial isolates from infected patients in Germany (2016–2021) and the case fatality rates (2010–2021). Random and fixed (common) effect models were used to calculate pooled proportions and pooled case fatality odds ratios, respectively. ResultsThe pooled proportion of meticillin resistance in Staphylococcus aureus infections (MRSA) was 7.9% with a declining trend between 2014 and 2020 (odds ratio (OR) = 0.89; 95% CI: 0.886–0.891; p
Læs mereStatens Serum Institut, 11.04.2023
Tilføjet 11.04.2023
Der var i 2013 en stor stigning i antallet af patienter, der fik infektioner med multiresistente bakterier som VRE og CPE på de danske hospitaler. Derimod fastholdtes antallet af hospitals MRSA infektioner på samme lave niveau som året før. Det viser årets DANMAP rapport fra Statens Serum Institut og DTU Fødevareinstituttet.
Læs mereStatens Serum Institut, 11.04.2023
Tilføjet 11.04.2023
ProMED, 27.01.2023
Tilføjet 27.01.2023
Avian Influenza H5N1 -- FranceA domestic cat was found to have been infected with bird flu, and ultimately euthanized after suffering severe neurological symptoms. The animal, which lived in Mauléon, Deux-Sèvres in Nouvelle-Aquitaine, picked up the virus from a nearby poultry farm that raised ducks, a report from France's health and food safety agency l'Agence Nationale De Sécurité Sanitaire de l'Alimentation, de l'Environnement et du Travail (Anses) states.This is the first time such a case has been observed
Læs mereProMED, 1.01.2023
Tilføjet 1.01.2023
Avian Influenza H5N1 -- FranceSummaryReport type: immediate notificationStarted: 20 Dec 2022Confirmed: 27 Dec 2022Reported: 28 Dec 2022Reason for notification: unusual host speciesCausal agent: highly pathogenic avian influenza virusSerotype: H5N1Nature of diagnosis: clinical, laboratoryThis event pertains to a defined zone within the country.Outbreak location: Mauleon, Deux-Sevres, Nouvell-AquitaineStarted: 20 Dec 2022Ended: 28 Dec 2022Epidemiological unit: farmTotal animals
Læs mereEurosurveillance latest updates, 1.12.2022
Tilføjet 2.12.2022
A large clonal outbreak caused by vancomycin-resistant Enterococcus faecium (VRE) affected the Bern University Hospital group from the end of December 2017 until July 2020. We describe the characteristics of the outbreak and the bundle of infection prevention and control (IPC) measures implemented. The outbreak was first recognised when two concomitant cases of VRE bloodstream infection were identified on the oncology ward. During 32 months, 518 patients in the 1,300-bed hospital group were identified as vanB VRE carriers. Eighteen (3.5%) patients developed an invasive infection, of whom seven had bacteraemia. In 2018, a subset of 328 isolates were analysed by whole genome sequencing, 312 of which were identified as sequence type (ST) 796. The initial IPC measures were implemented with a focus on the affected wards. However, in June 2018, ST796 caused another increase in cases, and the management strategy was intensified and escalated to a hospital-wide level. The clinical impact of this large nosocomial VRE outbreak with the emergent clone ST796 was modest. A hospital-wide approach with a multimodal IPC bundle was successful against this highly transmissible strain.
Læs mereSafiullah Najem, Dorothée Eick, Johannes Boettcher, Annette Aigner, Mona Aboutara, Ines Fenner, Konrad Reinshagen and Ingo Koenigs
Eurosurveillance latest updates, 14.04.2022
Tilføjet 15.04.2022
Background
Increasing resistance to antibiotics poses medical challenges worldwide. Prospective data on carriage prevalence of multidrug resistant organisms (MDRO) in children at hospital admission are limited and associated risk factors are poorly defined.
Aim
To determine prevalence of MDRO carriage in children at admission to our paediatric hospital in Hamburg and to identify MDRO carriage risk factors.
Methods
We prospectively obtained and cultured nasal/throat and inguinal/anal swabs from children (≤ 18 years) at admission between September 2018 and May 2019 to determine prevalence of meticillin-resistant Staphylococcus aureus (MRSA), multidrug-resistant Gram-negative bacteria (MRGN) and vancomycin-resistant enterococcus (VRE) and associated species. We collected medical histories using a questionnaire and evaluated 31 risk factors using logistic regression models.
Results
MDRO carriage prevalence of 3,964 children was 4.31% (95% confidence interval (CI): 3.69–5.00). MRSA carriage prevalence was 0.68% (95% CI: 0.44–0.99), MRGN prevalence was 3.64% (95% CI: 3.07–4.28) and VRE prevalence 0.08% (95% CI: 0.02–0.22). MDRO carriage was associated with MRGN history (odds ratio (OR): 6.53; 95% CI: 2.58–16.13), chronic condition requiring permanent care (OR: 2.67; 95% CI: 1.07–6.13), antibiotic therapy (OR: 1.92, 95% CI: 1.24–2.94), living in a care facility (OR: 3.34; 95% CI: 0.72–12.44) and refugee status in previous 12 months (OR: 1.91; 95% CI: 0.27–8.02). Compared to established practice, screening using risk-factors had better diagnostic sensitivity (86.13%; 95% CI: 80.89–91.40) and specificity (73.54%; 95% CI: 72.12–74.97).
Conclusion
MRGN carriage was higher than MRSA and VRE. Extended risk-factor-based admission screening system seems warranted.
Læs mereSamuel Alizon, Christian Selinger, Mircea T Sofonea, Stéphanie Haim-Boukobza, Jean-Marc Giannoli, Laetitia Ninove, Sylvie Pillet, Vincent Thibault, Alexis de Rougemont, Camille Tumiotto, Morgane Solis, Robin Stephan, Céline Bressollette-Bodin, Maud Salmona, Anne-Sophie L’Honneur, Sylvie Behillil, Caroline Lefeuvre, Julia Dina, Sébastien Hantz, Cédric Hartard, David Veyer, Héloïse M Delagrèverie, Slim Fourati, Benoît Visseaux, Cécile Henquell, Bruno Lina, Vincent Foulongne, Sonia Burrel and on behalf of the SFM COVID-19 study group
Eurosurveillance latest updates, 10.02.2022
Tilføjet 11.02.2022
Background
The COVID-19 pandemic has led to an unprecedented daily use of RT-PCR tests. These tests are interpreted qualitatively for diagnosis, and the relevance of the test result intensity, i.e. the number of quantification cycles (Cq), is debated because of strong potential biases.
Aim
We explored the possibility to use Cq values from SARS-CoV-2 screening tests to better understand the spread of an epidemic and to better understand the biology of the infection.
Methods
We used linear regression models to analyse a large database of 793,479 Cq values from tests performed on more than 2 million samples between 21 January and 30 November 2020, i.e. the first two pandemic waves. We performed time series analysis using autoregressive integrated moving average (ARIMA) models to estimate whether Cq data information improves short-term predictions of epidemiological dynamics.
Results
Although we found that the Cq values varied depending on the testing laboratory or the assay used, we detected strong significant trends associated with patient age, number of days after symptoms onset or the state of the epidemic (the temporal reproduction number) at the time of the test. Furthermore, knowing the quartiles of the Cq distribution greatly reduced the error in predicting the temporal reproduction number of the COVID-19 epidemic.
Conclusion
Our results suggest that Cq values of screening tests performed in the general population generate testable hypotheses and help improve short-term predictions for epidemic surveillance.
Læs mereCorinna Glasner, Matthijs S Berends, Karsten Becker, Jutta Esser, Jens Gieffers, Annette Jurke, Greetje Kampinga, Stefanie Kampmeier, Rob Klont, Robin Köck, Lutz von Müller, Nashwan al Naemi, Alewijn Ott, Gijs Ruijs, Katja Saris, Adriana Tami, Andreas Voss, Karola Waar, Jan van Zeijl and Alex W Friedrich
Eurosurveillance latest updates, 3.02.2022
Tilføjet 4.02.2022
Background
Antimicrobial resistance poses a risk for healthcare, both in the community and hospitals. The spread of multidrug-resistant organisms (MDROs) occurs mostly on a local and regional level, following movement of patients, but also occurs across national borders.
Aim
The aim of this observational study was to determine the prevalence of MDROs in a European cross-border region to understand differences and improve infection prevention based on real-time routine data and workflows.
Methods
Between September 2017 and June 2018, 23 hospitals in the Dutch (NL)–German (DE) cross-border region (BR) participated in the study. During 8 consecutive weeks, patients were screened upon admission to intensive care units (ICUs) for nasal carriage of meticillin-resistant Staphylococcus aureus (MRSA) and rectal carriage of vancomycin-resistant Enterococcus faecium/E. faecalis (VRE), third-generation cephalosporin-resistant Enterobacteriaceae (3GCRE) and carbapenem-resistant Enterobacteriaceae (CRE). All samples were processed in the associated laboratories.
Results
A total of 3,365 patients were screened (median age: 68 years (IQR: 57–77); male/female ratio: 59.7/40.3; NL-BR: n = 1,202; DE-BR: n = 2,163). Median screening compliance was 60.4% (NL-BR: 56.9%; DE-BR: 62.9%). MDRO prevalence was higher in DE-BR than in NL-BR, namely 1.7% vs 0.6% for MRSA (p = 0.006), 2.7% vs 0.1% for VRE (p < 0.001) and 6.6% vs 3.6% for 3GCRE (p < 0.001), whereas CRE prevalence was comparable (0.2% in DE-BR vs 0.0% in NL-BR ICUs).
Conclusions
This first prospective multicentre screening study in a European cross-border region shows high heterogenicity in MDRO carriage prevalence in NL-BR and DE-BR ICUs. This indicates that the prevalence is probably influenced by the different healthcare structures.
Læs mereLena M. Biehl, Paul G. Higgins, Jannik Stemler, Meyke Gilles, Silke Peter, Daniela Dörfel, Wichard Vogel, Winfried V. Kern, Hanna Gölz, Hartmut Bertz, Holger Rohde, Eva-Maria Klupp, Philippe Schafhausen, Jon Salmanton-García, Melanie Stecher, Julia Wille, Blasius Liss, Kyriaki Xanthopoulou, Janine Zweigner, Harald Seifert and Maria J.G.T. Vehreschild
Eurosurveillance latest updates, 13.01.2022
Tilføjet 14.01.2022
Background
Evidence supporting the effectiveness of single-room contact precautions (SCP) in preventing in-hospital acquisition of vancomycin-resistant enterococci (haVRE) is limited.
Aim
We assessed the impact of SCP on haVRE and their transmission.
Methods
We conducted a prospective, multicentre cohort study in German haematological/oncological departments during 2016. Two sites performed SCP for VRE patients and two did not (NCP). We defined a 5% haVRE-risk difference as non-inferiority margin, screened patients for VRE, and characterised isolates by whole genome sequencing and core genome MLST (cgMLST). Potential confounders were assessed by competing risk regression analysis.
Results
We included 1,397 patients at NCP and 1,531 patients at SCP sites. Not performing SCP was associated with a significantly higher proportion of haVRE; 12.2% (170/1,397) patients at NCP and 7.4% (113/1,531) patients at SCP sites (relative risk (RR) 1.74; 95% confidence interval (CI): 1.35–2.23). The difference (4.8%) was below the non-inferiority margin. Competing risk regression analysis indicated a stronger impact of antimicrobial exposure (subdistribution hazard ratio (SHR) 7.46; 95% CI: 4.59–12.12) and underlying disease (SHR for acute leukaemia 2.34; 95% CI: 1.46–3.75) on haVRE than NCP (SHR 1.60; 95% CI: 1.14–2.25). Based on cgMLST and patient movement data, we observed 131 patient-to-patient VRE transmissions at NCP and 85 at SCP sites (RR 1.76; 95% CI: 1.33–2.34).
Conclusions
We show a positive impact of SCP on haVRE in a high-risk population, although the observed difference was below the pre-specified non-inferiority margin. Importantly, other factors including antimicrobial exposure seem to be more influential.
Læs mere