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Background: The Netherlands is currently considered a low endemic country for carbapenem-resistant Enterobacterales (CRE) and carbapenemase-producing Enterobacterales (CPE), experiencing only sporadic hospital outbreaks. This study aims to describe susceptibility to carbapenems and the epidemiology of carbapenemase production in Enterobacterales in the Netherlands in 2017–2019. Methods: Three complementary nationwide surveillance systems are in place to monitor carbapenem susceptibility in the Netherlands. Routine antimicrobial susceptibility test results from medical microbiology laboratories were used to study phenotypic susceptibility of Escherichia coli and Klebsiella pneumoniae. Pathogen surveillance (of all Enterobacterales species) and mandatory notifications were used to describe the characteristics of CPE positive isolates and affected persons. Results: The prevalence of isolates with gradient strip test-confirmed elevated meropenem (> 0.25 mg/L) or imipenem (> 1 mg/L) minimum inhibitory concentration (MIC) in the Netherlands was very low in 2017–2019, with percentages of 0.06% in E. coli and 0.49% in K. pneumoniae, and carbapenem resistances of 0.02% and 0.18%, respectively. A total of 895 unique species/carbapenemase-encoding allele combinations of CPE from 764 persons were submitted between 2017 and 2019, with the annual number of submissions increasing slightly each year. Epidemiological data was available for 660 persons. Screening because of presumed colonisation risk was the reason for sampling in 70.0% (462/660) of persons. Hospitalization abroad was the most common risk factor, being identified in 45.9% of persons. Conclusions: Carbapenem resistance of E. coli and K. pneumoniae remains low in the Netherlands. The annual number of CPE isolates slightly increased during the period 2017–2019. Recent hospitalization abroad is the main risk factor for acquisition of CPE. [ABSTRACT FROM AUTHOR]

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Effects of regular treatments with the fungicides carbendazim and prochloraz applied to whole plots divided into subplots with different initial population mixtures of carbendazim-sensitive or carbendazim-resistant Tapesia yallundae or T. acuformis were studied in successive crops of winter wheat from 1984/85 to 1999/2000. In unsprayed and carbendazim-sprayed whole plots, a stable coexistence of about 50% each of T. yallundae and T. acuformis developed within five seasons, but in whole plots sprayed with prochloraz or prochloraz plus carbendazim, the proportion of T. acuformis increased to > 80%. A discrete time difference equation model was derived from knowledge of the biology of eyespot and competition theory to describe the population changes. The model was fitted to the data from treatments where coexistence occurred [subplots in unsprayed (1985–92) and carbendazim-sprayed (1985–89) whole plots], using nonlinear least squares regression. The optimized value of the resource overlap coefficient was small, suggesting niche differences between the two species. Populations were nearly 100% carbendazim-resistant in carbendazim-sprayed whole plots by July 1985 (one season) and in whole plots sprayed with prochloraz plus carbendazim by July 1986 (two seasons). In prochloraz-sprayed whole plots, the proportion of carbendazim-resistant isolates decreased more rapidly than in unsprayed whole plots in the 1980s, but by July 1992 a shift in populations in unsprayed and prochloraz-sprayed whole plots towards predominantly carbendazim-resistant strains had occurred. [ABSTRACT FROM AUTHOR]

Making a distinction between facial palsy due to Lyme neuroborreliosis (LNB) and idiopathic facial palsy (IFP) is of importance to ensure timely and adequate treatment. The study objective was to assess incidence and patient characteristics of facial palsy due to LNB. Hospital records were reviewed of adult patients with facial palsy visiting the departments of neurology and/or otorhinolaryngology of Gelre hospitals between June 2007 and December 2017. Gelre hospitals are located in an area endemic for Lyme borreliosis. Patients with LNB had pleocytosis and intrathecal antibody production or pleocytosis with positive IgG serology. Patients with IFP had negative serology. Clinical characteristics were compared between patients with LNB and patients with IFP. Five hundred and fifty-nine patients presented with facial palsy, 4.7% (26) had LNB and 39.4% (220) IFP. The incidence of facial palsy due to LNB was 0.9/100 000 inhabitants/year. Over 70% of patients with facial palsy due to LNB did not report a recent tick bite and/or erythema migrans (EM). Patients with facial palsy due to LNB presented more often in July to September (69.2% vs. 21.9%, P < 0.001), and had more often headache (42.3% vs. 15.5%, P < 0.01). To reduce the risk of underdiagnosing LNB in an endemic area, we recommend testing for LNB in patients with facial palsy in summer months especially when presenting with headache, irrespective of a recent tick bite and/or EM. [ABSTRACT FROM AUTHOR]

We present a case of ovarian fibroma with associated Meigs syndrome, Even though the CT findings of ovarian fibroma have been reported previously, our case, with associated meigs syndrome, demonstrated a broader spectrum of CT findings.

A retrospective survey was performed to study the clinical course of 375 patients with genital herpes simplex infections seen between 1973 and 1980. Genital herpes simplex is increasingly being recognized as a disease of the affluent middle class. Recurrences in this study were most frequently associated with emotional stress (85.9 percent) and by coital friction (66 percent). The enormous psychological burden of this disease resulted in 42 percent of the patients withdrawing from sexual encounters. The study suggests a relatively low index of communicability (25.3 percent) to sexual partners even though neither topical nor systemically administered therapeutic agents seemed to significantly influence the course of disease. When curves were constructed based on patients' statements as to when they experienced a period of protracted remission from disease, 50 percent of those with genital herpes simplex were found to be essentially free of frequently recurring episodes within seven years after the onset of disease.

48 patients participated in a double-blind placebo-controlled study conducted to evaluate the efficacy of ribavirin in the treatment of herpes simplex virus genital infection. Study design did not allow a conclusion regarding usefulness of the drug in preventing recurrences. Ribavirin treatment (800 mg/day p.o) for 10 days reduced disease severity and promoted recovery as compared with placebo treatment.

A double-blind cross-over study of the immunoprophylactic influence of levamisole was undertaken in a study of forty patients with chronic, recurrent herpes progenitalis. Clinical records failed to show significant reduction in the frequency or severity of attacks in levamisole-treated patients when compared with placebo-treated control patients. At evaluation six months after levamisole administration, there was no essential alteration in the course of the disease in the initial treatment group.

It may be possible to eliminate Herpes simplex virus (HSV) from the skin of patients with chronic recurrent genital infections through destruction of the cutaneous sensory nerves of the genitals by injecting absolute alcohol into the affected areas. In so doing the latency of the virus in the sensory ganglia may be influenced, the immediate source of reinfection suppressed, and reactivation of HSV inhibited in the skin.