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6. Variation in paediatric hospital antibiotic guidelines in Europe

Author

Spyridis, N, Syridou, G, Goossens, H, Versporten, A, Kopsidas, J, Kourlaba, G, Bielicki, J, Drapier, N, Zaoutis, T, Tsolia, M, Sharland, M, Vergison, A, Léon, V, Delestrait, M, Huza, C, Lepage, P, Mahieu, L, Boy, T, Jansens, H, Van der Linden, D, Briquet, C, Allegaert, K, Smits, A, Gabriels, P, Vuye, A, Lutsar, I, Tamm, E, Larionova, A, Laan, D, Orbach, M, Lorrot, M, Angoulvant, F, Prot-Labarthe, S, Dubos, F, Lagree, M, Hufnagel, M, Schuster, K, Henneke, P, Roilides, E, Iosifidis, E, Corovessi, V, Michos, A, Galanakis, E, Gkentzi, D, Giacquinto, C, Longo, G, Dona, D, Mion, T, DʼArgenio, P, Degli, ML Ciofi, De Luca, M, Ciliento, G, Esposito, S, Danieli, E, Montinaro, V, Tenconi, R, Nicolini, G, Sviestina, C I Montagnani, Pavare, J, Rasnaca, K, Gardovska, D, Grope, I, Usonis, V, Gurksniene, V, Eidukaite, A, Biver, A, Brett, A, Esteves, I, Cambrea, SC, Craiu, M, Tomescu, E, Cizman, M, Babnik, J, Kenda, R, Vidmar, I, Nunez-Cuadros, E, Rojo, P, Lopez-Varela, E, Ureta, N, Mosqueda, R, Perez-Lopez, A, Orta, L, Santos, M, Navarro, M, Santiago, B, Hernandez-Sampelaya, T, Saavedra, J, Pineiro, R, Torel, P, Mate Cano, I, Baumann, P, Berger, C, Menson, E, Botgros, A, Doerholt, K, Drysdale, S, Makwana, N, McCorry, A, Garbash, EM, Chetcutiganado, C, McLeod, M, Caldwell, N, Nash, C, McCullagh, B, Sharpe, D, Tweddell, L, Liese, JG, Aston, J, Gallagher, A, Satodia, P, Howard-Smith, N, Korinteli, I, Tavchioska, G, Jensen, L, Trethon, A, Unuk, S, Childs, N, and Canlas, J

Published
2016
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7. Organization and training at national level of antimicrobial stewardship and infection control activities in Europe: an ESCMID cross-sectional survey

Author

Maraolo, AE, Ong, DSY, Cimen, C, Howard, P, Kofteridis, DP, Schouten, J, Mutters, NT, Pulcini, C, Harxhi, A, Presterl, E, Zeller, I, Wechsler- Fördös, A, Gurbanov, A, Vandendriessche, S, Jansens, H, Kostyanev, T, Vatcheva-Dobrevska, R, Sabolić, M, Civljak, R, Vlahović-Palčevski, Vera, Trojanek, M, Yiannitsarou, M, Tsioutis, C, Obrink-Hansen, K, Olesen, B, Jaaniso, K, Ala-Houhala, M, Jarlier, V, Bleibtreu, A, Zapf, TC, Kern, WV, Mattner, F, Zaragkoulias, K, Tsakris, A, Hajdú, E, Prinz, G, Gergely, SB, Doherty, A, Schaffer, K, Fleming, A, Hussein, K, Carrara, E, Pagani, L, Giacobbe, DR, Ponosheci-Bicaku, A, Raka, L, Krasniqi, S, Grāmatniece, A, Dumpis, U, Valinteliene, R, Kacergius, T, Knepper, V, Zarb, P, Wagenvoort, G, Voss, A, Akselsen, PE, Berild, D, Kubiak, J, Deptuła, A, Wanke-Rytt, M, de Sousa Fernandes, FS, Rocha-Pereira, N, Palos, C, Kostova, NM, Iacob, DG, Sandulescu, O, Filip, R, Barac, A, Krčméry, V, Plesko, M, Zupanc, TL, Beović, B, Pardo, JRP, Horcajada, JP, Baena, ZP, Tängdén, T, Johansson, A, Rönnberg, C, Huttner, B, Zingg, W, Akova, M, Ergönül, Ö, Holmes, A, Cevik, M, Salmanov, A, National Institute for Health Research, ESGAP-EUCIC-TAE Working Group on AMS/IPC mapping in Europe, University of St Andrews. School of Medicine, University of Naples Federico II, Sint Franciscus Gasthuis, University Medical Center [Utrecht], Ardahan Public Hospital, Leeds Teaching Hospitals NHS Trust, University Hospital of Heraklion, Radboud University Medical Center [Nijmegen], University of Freiburg [Freiburg], Service des Maladies Infectieuses et Tropicales [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Maladies chroniques, santé perçue, et processus d'adaptation (APEMAC), and Université de Lorraine (UL)

Subjects
0301 basic medicine, Cross-sectional study, Antimicrobial stewardship, BIOMEDICINA I ZDRAVSTVO. Kliničke medicinske znanosti. Klinička farmakologija s toksikologijom, BIOMEDICINE AND HEALTHCARE. Clinical Medical Sciences. Medical Microbiology, 0302 clinical medicine, Hospital Administration, Surveys and Questionnaires, Medical Laboratory Personnel, Infection control, QR180 Immunology, 030212 general & internal medicine, 11 Medical and Health Sciences, Infection prevention and control, Clinical microbiology, Infectious diseases, Questionnaire, General Medicine, 3. Good health, Europe, Infectious Diseases, Infection -- Prevention, QR180, Respondent, Anti-infective agents, Original Article, Education, Medical, Continuing, Infection -- Control, Microbiology (medical), medicine.medical_specialty, 030106 microbiology, NDAS, Specialty, Staffing, Microbiology, 03 medical and health sciences, All institutes and research themes of the Radboud University Medical Center, SDG 3 - Good Health and Well-being, parasitic diseases, medicine, Humans, National level, cardiovascular diseases, Infection Control, Infection Control Practitioners, business.industry, Medical microbiology -- Case studies, 06 Biological Sciences, BIOMEDICINE AND HEALTHCARE. Clinical Medical Sciences. Clinical Pharmacology and Toxicology, lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4], Cross-Sectional Studies, Family medicine, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, BIOMEDICINA I ZDRAVSTVO. Kliničke medicinske znanosti. Medicinska mikrobiologija
Abstract

Antimicrobial stewardship (AMS) and Infection prevention and control (IPC) are two key complementary strategies that combat development and spread of antimicrobial resistance. The ESGAP (ESCMID Study Group for AMS), EUCIC (European Committee on Infection Control) and TAE (Trainee Association of ESCMID) investigated how AMS and IPC activities and training are organized, if present, at national level in Europe. From February 2018 to May 2018, an internet-based cross-sectional survey was conducted through a 36-item questionnaire, involving up to three selected respondents per country, from 38 European countries in total (including Israel), belonging to the ESGAP/EUCIC/TAE networks. All 38 countries participated with at least one respondent, and a total of 81 respondents. Education and involvement in AMS programmes were mandatory during the postgraduate training of clinical microbiology and infectious diseases specialists in up to one-third of countries. IPC was acknowledged as a specialty in 32% of countries. Only 32% of countries had both guidance and national requirements regarding AMS programmes, in contrast to 61% for IPC. Formal national staffing standards for AMS and IPC hospital-based activities were present in 24% and 63% of countries, respectively. The backgrounds of professionals responsible for AMS and IPC programmes varied tremendously between countries. The organization and training of AMS and IPC in Europe are heterogeneous and national requirements for activities are frequently lacking., peer-reviewed

Published
2019
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10. The worldwide Antibiotic Resistance and Prescribing in European Children (ARPEC) point prevalence survey: developing hospital-quality indicators of antibiotic prescribing for children

Author

Versporten A1, Bielicki J2, Drapier N1, Sharland M2, Goossens H3, ARPEC project group. Calle GM, Garrahan JP, Clark J, Cooper C, Blyth CC, Francis JR, Alsalman J, Jansens H, Mahieu L, Van Rossom P, Vandewal W, Lepage P, Blumental S, Briquet C, Robbrecht D, Maton P, Gabriels P, Rubic Z, Kovacevic T, Nielsen JP, Petersen JR, Poorisrisak P, Jensen LH, Laan M, Tamm E, Matsinen M, Rummukainen ML, Gajdos V, Olivier R, Le Maréchal F, Martinot A, Dubos F, Lagrée M, Prot-Labarthe S, Lorrot M, Orbach D, Pagava K, Hufnagel M, Knuf M, Schlag SA, Liese J, Renner L, Enimil A, Awunyo M, Syridou G, Spyridis N, Critselis E, Kouni S, Mougkou K, Ladomenou F, Gkentzi D, Iosifidis E, Roilides E, Sahu S, Murki S, Malviya M, Kalavalapalli DB, Singh S, Singhal T, Garg G, Garg P, Kler N, Soltani J, Jafarpour Z, Pouladfar G, Nicolini G, Montagnani C, Galli L, Esposito S, Tenconi R, Lo Vecchio A, Dona' D, Giaquinto C, Borgia E, D'Argenio P, De Luca M, Centenari C, Raka L, Raka D, Omar A, Al-Mousa H, Mozgis D, Sviestina I, Burokiene S, Usonis V, Tavchioska G, Hargadon-Lowe A, Zarb P, Borg MA, González Lozano CA, Zárate Castañon P, Cancino ME, McCullagh B, McCorry A, Gormley C, Al Maskari Z, Al-Jardani A, Pluta M, Rodrigues F, Brett A, Esteves I, Marques L, Ali AlAjmi J, Claudia Cambrea S, Rashed AN, Mubarak Al Azmi AA, Chan SM, Isa MS, Najdenov P, Čižman M, Unuk S, Finlayson H, Dramowski A, Maté-Cano I, Soto B, Calvo C, Santiago B, Saavedra-Lozano J, Bustinza A, Escosa-García L, Ureta N, Lopez-Varela E, Rojo P, Tagarro A, Barrero PT, Rincon-Lopez EM, Abubakar I, Aston J, Heginbothom M, Satodia P, Garbash M, Johnson A, Sharpe D, Barton C, Menson E, Arenas-Lopez S, Luck S, Doerholt K, McMaster P, Caldwell NA, Lunn A, Drysdale SB, Howe R, Scorrer T, Gahleitner F, Gupta R, Nash C, Alexander J, Raman M, Bell E, Rajagopal V, Kohlhoff S, Cox E, Zaoutis T., Mahieu, Ludo, ARPEC Project Grp, ARPEC project group, Versporten, A1, Bielicki, J2, Drapier, N1, Sharland, M2, Goossens, H3, ARPEC project group., Calle GM, Garrahan, Jp, Clark, J, Cooper, C, Blyth, Cc, Francis, Jr, Alsalman, J, Jansens, H, Mahieu, L, Van Rossom, P, Vandewal, W, Lepage, P, Blumental, S, Briquet, C, Robbrecht, D, Maton, P, Gabriels, P, Rubic, Z, Kovacevic, T, Nielsen, Jp, Petersen, Jr, Poorisrisak, P, Jensen, Lh, Laan, M, Tamm, E, Matsinen, M, Rummukainen, Ml, Gajdos, V, Olivier, R, Le Maréchal, F, Martinot, A, Dubos, F, Lagrée, M, Prot-Labarthe, S, Lorrot, M, Orbach, D, Pagava, K, Hufnagel, M, Knuf, M, Schlag, Sa, Liese, J, Renner, L, Enimil, A, Awunyo, M, Syridou, G, Spyridis, N, Critselis, E, Kouni, S, Mougkou, K, Ladomenou, F, Gkentzi, D, Iosifidis, E, Roilides, E, Sahu, S, Murki, S, Malviya, M, Kalavalapalli, Db, Singh, S, Singhal, T, Garg, G, Garg, P, Kler, N, Soltani, J, Jafarpour, Z, Pouladfar, G, Nicolini, G, Montagnani, C, Galli, L, Esposito, S, Tenconi, R, Lo Vecchio, A, Dona', D, Giaquinto, C, Borgia, E, D'Argenio, P, De Luca, M, Centenari, C, Raka, L, Raka, D, Omar, A, Al-Mousa, H, Mozgis, D, Sviestina, I, Burokiene, S, Usonis, V, Tavchioska, G, Hargadon-Lowe, A, Zarb, P, Borg, Ma, González Lozano, Ca, Zárate Castañon, P, Cancino, Me, Mccullagh, B, Mccorry, A, Gormley, C, Al Maskari, Z, Al-Jardani, A, Pluta, M, Rodrigues, F, Brett, A, Esteves, I, Marques, L, Ali AlAjmi, J, Claudia Cambrea, S, Rashed, An, Mubarak Al Azmi, Aa, Chan, Sm, Isa, M, Najdenov, P, Čižman, M, Unuk, S, Finlayson, H, Dramowski, A, Maté-Cano, I, Soto, B, Calvo, C, Santiago, B, Saavedra-Lozano, J, Bustinza, A, Escosa-García, L, Ureta, N, Lopez-Varela, E, Rojo, P, Tagarro, A, Barrero, Pt, Rincon-Lopez, Em, Abubakar, I, Aston, J, Heginbothom, M, Satodia, P, Garbash, M, Johnson, A, Sharpe, D, Barton, C, Menson, E, Arenas-Lopez, S, Luck, S, Doerholt, K, Mcmaster, P, Caldwell, Na, Lunn, A, Drysdale, Sb, Howe, R, Scorrer, T, Gahleitner, F, Gupta, R, Nash, C, Alexander, J, Raman, M, Bell, E, Rajagopal, V, Kohlhoff, S, Cox, E, and Zaoutis, T.

Subjects
0301 basic medicine, Male, Pediatrics, Latin Americans, Cross-sectional study, Prevalence, Psychological intervention, Drug resistance, Global Health, infectious diseases, 0302 clinical medicine, Global health, Medicine, 030212 general & internal medicine, Child, antibiotics, children, Drugs -- Prescribing, Pharmacology. Therapy, Hospitals -- Europe, Drug Resistance, Microbial, Hospitals, Anti-Bacterial Agents, Europe, Child, Preschool, Anti-infective agents, Female, medicine.drug, Microbiology (medical), medicine.medical_specialty, Cefepime, 030106 microbiology, Drug Prescriptions, 03 medical and health sciences, Surgical prophylaxis, pharmacology, pharmacology (medical), Environmental health, Humans, Biology, Quality Indicators, Health Care, business.industry, Health status indicators -- Europe, Infant, Drug Utilization, Cross-Sectional Studies, Health Care Surveys, Human medicine, business
Abstract

Objectives: Previously, web-based tools for cross-sectional antimicrobial point prevalence surveys (PPSs) have been used in adults to develop indicators of quality improvement. We aimed to determine the feasibility of developing similar quality indicators of improved antimicrobial prescribing focusing specifically on hospitalized neonates and children worldwide. Methods: A standardized antimicrobial PPS method was employed. Included were all inpatient children and neonates receiving an antimicrobial at 8:00 am on the day of the PPS. Denominators included the total number of inpatients. A web-based application was used for data entry, validation and reporting. We analysed 2012 data from 226 hospitals (H) in 41 countries (C) from Europe (174H; 24C), Africa (6H; 4C), Asia (25H; 8C), Australia (6H), Latin America (11H; 3C) and North America (4H). Results: Of 17693 admissions, 6499 (36.7%) inpatients received at least one antimicrobial, but this varied considerably between wards and regions. Potential indicators included very high broad-spectrum antibiotic prescribing in children of mainly ceftriaxone (ranked first in Eastern Europe, 31.3%; Asia, 13.0%; Southern Europe, 9.8%), cefepime (ranked third in North America, 7.8%) and meropenem (ranked first in Latin America, 13.1%). The survey identified worryingly high use of critically important antibiotics for hospital-acquired infections in neonates (34.9%; range from 14.2% in Africa to 68.0% in Latin America) compared with children (28.3%; range from 14.5% in Africa to 48.9% in Latin America). Parenteral administration was very common among children in Asia (88%), Latin America (81%) and Europe (67%). Documentation of the reasons for antibiotic prescribing was lowest in Latin America (52%). Prolonged surgical prophylaxis rates ranged from 78% (Europe) to 84% (Latin America). Conclusions: Simple web-based PPS tools provide a feasible method to identify areas for improvement of antibiotic use, to set benchmarks and to monitor future interventions in hospitalized neonates and children. To our knowledge, this study has derived the first global quality indicators for antibiotic use in hospitalized neonates and children., peer-reviewed

Published
2018

11. Multidisciplinary study of the secondary immune response in grandparents re-exposed to chickenpox (vol 7, 1077, 2017)

Author

Ogunjimi, B, Van den Bergh, J, Meysman, P, Heynderickx, S, Bergs, K, Jansens, H, Leuridan, E, Vorsters, A, Goossens, H, Laukens, K, Cools, N, Van Tendeloo, Viggo, Hens, N, Van Damme, P, Smits, Evelien, Beutels, Ph, and Pediatrics

Subjects
general, ComputingMethodologies_DOCUMENTANDTEXTPROCESSING
Abstract

The original version of this Article contained an error in the spelling of H. Jansens, which was incorrectly given as H. Jansen in the Article, and as H. Janssen in the Supplementary Information file. This has now been corrected in the HTML and PDF versions of this Article, and in the Supplementary Information file.

Published
2018

13. Variation in paediatric hospital antibiotic guidelines in Europe

Author

Spyridis, N., Syridou, G., Goossens, H., Versporten, A., Kopsidas, J., Kourlaba, G., Bielicki, J., Drapier, N., Zaoutis, T., Tsolia, M., Sharland, M., Vergison, A., Leon, V., Delestrait, M., Huza, C., Lepage, P., Mahieu, L., Boy, T., Jansens, H., Van Der Linden, D., Briquet, C., Allegaert, K., Smits, A., Gabriels, P., Vuye, A., Lutsar, I., Tamm, E., Larionova, A., Laan, D., Orbach, M., Lorrot, M., Angoulvant, F., Prot-Labarthe, S., Dubos, F., Lagree, M., Hufnagel, M., Schuster, K., Henneke, P., Roilides, E., Iosifidis, E., Corovessi, V., Michos, A., Galanakis, E., Gkentzi, D., Giacquinto, C., Longo, G., Dona', D., Mion, T., D'Argenio, P., Degli, M. L. C., De Luca, M., Ciliento, G., Esposito, S., Danieli, E., Montinaro, V., Tenconi, R., Nicolini, G., Sviestina, C. I. M., Pavare, J., Rasnaca, K., Gardovska, D., Usonis, V., Grope, I., Gurksniene, V., Eidukaite, A., Biver, A., Brett, A., Esteves, I., Cambrea, S. C., Craiu, M., Tomescu, E., Cizman, M., Babnik, J., Kenda, R., Vidmar, I., Nunez-Cuadros, E., Rojo, P., Lopez-Varela, E., Ureta, N., Perez-Lopez, A., Mosqueda, R., Orta, L., Santos, M., Navarro, M., Santiago, B., Hernandez-Sampelaya, T., Saavedra, J., Pineiro, R., Torel, P., Cano, I. M., Baumann, P., Berger, C., Menson, E., Botgros, A., Doerholt, K., Drysdale, S., Makwana, N., Mccorry, A., Garbash, E. M., Chetcutiganado, C., Mcleod, M., Caldwell, N., Nash, C., Mccullagh, B., Sharpe, D., Tweddell, L., Liese, J. G., Aston, J., Gallagher, A., Satodia, P., Howard-Smith, N., Korinteli, I., Tavchioska, G., Jensen, L., Trethon, A., Unuk, S., Childs, N., Canlas, J., Mahieu, Ludo, and ARPEC Project Grp

Subjects
Pediatrics, practice guidelines as topic, Antibiotics, cross-sectional studies, respiratory tract infections, sepsis, 0302 clinical medicine, newborn, Medicine, 030212 general & internal medicine, Practice Patterns, Physicians', humans, European paediatric hospitals, antibiotic guidelines, childhood infection, anti-bacterial agents, bacterial infections, child, preschool, drug administration schedule, drug prescriptions, Europe, hospitals, pediatric, infant, practice patterns, physicians', urinary tract infections, pediatrics, perinatology and child health, Antistaphylococcal penicillins, Respiratory tract infections, Neonatal sepsis, Hospitals, Pediatric, Child, Preschool, medicine.drug, medicine.medical_specialty, medicine.drug_class, Sepsis, 03 medical and health sciences, 030225 pediatrics, Internal medicine, business.industry, Infant, Newborn, Guideline, Amoxicillin, medicine.disease, Penicillin, Pediatrics, Perinatology and Child Health, Human medicine, business
Abstract

ObjectiveTo assess the availability and source of guidelines for common infections in European paediatric hospitals and determine their content and characteristics.DesignParticipating hospitals completed an online questionnaire on the availability and characteristics of antibiotic prescribing guidelines and on empirical antibiotic treatment including duration of therapy for 5 common infection syndromes: respiratory tract, urinary tract, skin and soft tissue, osteoarticular and sepsis in neonates and children.Results84 hospitals from 19 European countries participated in the survey of which 74 confirmed the existence of guidelines. Complete guidelines (existing guidelines for all requested infection syndromes) were reported by 20% of hospitals and the majority (71%) used a range of different sources. Guidelines most commonly available were those for urinary tract infection (UTI) (74%), neonatal sepsis (71%) and sepsis in children (65%). Penicillin and amoxicillin were the antibiotics most commonly recommended for respiratory tract infections (RTIs) (up to 76%), cephalosporin for UTI (up to 50%) and for skin and soft tissue infection (SSTI) and bone infection (20% and 30%, respectively). Antistaphylococcal penicillins were recommended for SSTIs and bone infections in 43% and 36%, respectively. Recommendations for neonatal sepsis included 20 different antibiotic combinations. Duration of therapy guidelines was mostly available for RTI and UTI (82%). A third of hospitals with guidelines for sepsis provided recommendations for length of therapy.ConclusionsComprehensive antibiotic guideline recommendations are generally lacking from European paediatric hospitals. We documented multiple antibiotics and combinations for most infections. Considerable improvement in the quality of guidelines and their evidence base is required, linking empirical therapy to resistance rates.

Published
2015
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14. The seroprevalence of cytomegalovirus infection in Belgium anno 2002 and 2006: a comparative analysis with hepatitis A virus seroprevalence

Author

UCL - SSS/IRSS - Institut de recherche santé et société, Smit, G. S. A., Abrams, S., Dorny, P., Speybroeck, Niko, Devleesschauwer, B., Hutse, V., Jansens, H., Theeten, H., Beutels, P., Hens, N., UCL - SSS/IRSS - Institut de recherche santé et société, Smit, G. S. A., Abrams, S., Dorny, P., Speybroeck, Niko, Devleesschauwer, B., Hutse, V., Jansens, H., Theeten, H., Beutels, P., and Hens, N.

Abstract

Cytomegalovirus (CMV) infection is endemic worldwide but its seroprevalence varies widely.The goal of this study was to estimate the age-specific seroprevalence of CMV infection in Belgium based on two cross-sectional serological datasets from 2002 and 2006. The seroprevalence was estimated relying on diagnostic test results based on cut-off values pre-specified by the manufacturers of the tests as well as relying on mixture models applied to continuous pathogen-specific immunoglobulin G antibody titre concentrations. The age-specific seroprevalence of hepatitis A virus (HAV), based on three Belgian cross-sectional serological datasets from 1993, 2002 and 2006, was used as a comparator since individuals acquire lifelong immunity upon recovery, implying an increasing seroprevalence with age. The age group weighted overall CMV seroprevalence derived from the mixture model was 32% (95% confidence interval (CI) 31–34%) in 2002 and 31% (95% CI 30–32%) in 2006. We demonstrated that CMV epidemiology differs from the immunizing infection HAV. This was the first largescale study of CMV and HAV serial datasets in Belgium, estimating seroprevalence specified by age and birth cohort.

Published
2019

17. Author Correction: Multidisciplinary study of the secondary immune response in grandparents re-exposed to chickenpox

Author

Ogunjimi, B., primary, Van den Bergh, J., additional, Meysman, P., additional, Heynderickx, S., additional, Bergs, K., additional, Jansens, H., additional, Leuridan, E., additional, Vorsters, A., additional, Goossens, H., additional, Laukens, K., additional, Cools, N., additional, Van Tendeloo, Viggo, additional, Hens, N., additional, Van Damme, P., additional, Smits, Evelien, additional, and Beutels, Ph., additional

Published
2018
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18. World alliance against antibiotic resistance: The WAAAR declaration against antibiotic resistance

Author

Carlet, J, Aaron, L, Abassi, M, Abbo, L, Aboderin, O, Abraham, E, Abroug, F, Acar, J, Achour, W, Adachi, J, Al-Abri, S, Al-Mousa, H, Albaya-Moreno, A, Alberti, C, Alfandari, S, Alnimr, A, Aranda, C, de Lerma, F, Amer, F, Andremont, A, Angoulvant, F, Anguill, M, Antonelli, M, Antoniadou, E, Arlet, G, Armaganidis, A, Arnera, A, Artigas, A, Attali, C, Auber, F, Aubert, J, Augereau, B, Aupee, M, Bahri, O, Ballereau, F, Bapt, G, Baquero, F, Barkhan, T, Barouti, O, Barthelemy, M, Barton, G, Bastoni, D, Baussier, M, Bavestrello, L, Beger, B, Benenson, S, Bensalem, F, Beraud, G, Bergheau, F, Bernard, G, Berthelot, P, Bertrand, X, Beuhorry-Sassus, F, Beuret, P, Billington, J, Birge, J, Biscardi, S, Blanch, L, Blanchard, H, Bleck, T, Blondeau, J, Blot, F, Borgey, F, Bousquet-Melou, A, Brami, J, Brard, C, Bretagne, S, Bretonniere, C, Brink, A, Brown, S, Bruant-Rodier, C, Brun-Buisson, C, Bruneel, F, de Carvalho, F, Buhot, C, Bukharie, H, Cabie, A, Calandra, T, Caniaux, I, Canica, M, Canton, R, Carenco, P, Carlet, C, Carlet, F, Carlet, R, Cars, O, Cassiano-Neves, M, Castan, B, Castellan, V, Cazenave-Roblot, F, Ceretti, A, Chakarian, J, Chalumeau-Lemoine, L, Chandy, J, Chanfreau, B, Chastre, J, Chausset, R, Chavanet, P, Cheadle, W, Chiche, J, Chidiac, C, Chosidow, O, Chueca, N, Cohen, J, Cohen, R, Collignon, P, Collot, F, Coloby, P, Conly, J, Cordero, C, Cordonnier, C, Corso, A, Cosgrove, S, Courcol, R, Crane, S, Craven, D, Crespin, A, Cyrillo, M, Danin, P, Waele, J, Dellamonica, P, Patchen Dellinger, E, Dellinger, P, Delmont, J, Denes, E, Dimopoulos, G, Drekonja, D, Mansilla, A, Druais, P, Dufour-Pierrat, S, Dumartin, C, Dunser, M, Dupont, M, Durlach, R, Dyar, O, Echaniz, G, Edelstein, P, Eggimann, P, Elghonemi, M, Elmdaghri, N, Elsaid, R, Elsokari, R, Engelhard, D, Fabry, J, Farmer, C, Fernandez, J, Finfer, S, Finn, P, Fjeldsted, K, Floret, D, Flozaro, F, Foegle, J, Forceville, X, Fournier, S, Frachon, I, Friedrich, A, Funuel, P, Gaillard, D, Gaillat, J, Galperine, T, Gambarotto, K, Garo, B, Garrouste-Orgeas, M, Gastemeier, P, Gauchot, J, Gauzit, R, Gavazzi, G, Gazagne, L, Gerberding, J, Ghafur, A, Giamarellos-Bourboulis, E, Giamarellou, E, Giard, M, Gilchrist, M, Gilquin, J, Gilsanz, F, Gniadkowski, M, Gogos, C, Goldman, D, Gordon, F, Gottlieb, T, Gould, I, Gouveia, J, Grant, J, Grason, L, Greder, A, Grundman, H, Guaguere, E, Gueroult-Locher, G, Guery, B, Guidet, B, Guignabert, C, Gupta, P, Gupta, S, Gurjar, M, Guzman, M, Hajjar, J, Hammad, N, Hammerum, A, Hanberger, H, Hanke, R, Harbarth, S, Harel, A, Heisbourg, E, Hermes, I, Hermet, J, Hirschel, B, Hoen, B, Hollis, A, Honghong, X, Hooper, D, Horcajada, J, Housset, B, Hryniewicz, W, Hsu, L, Huang, S, Hughes, J, Hunault, J, Jakobsen, L, Jalil, N, Jansens, H, Jarlier, V, Jarvis, W, Jean, D, Jereb, M, Johnson, J, Joly-Guillou, M, Jonquet, O, Kac, G, Kaddu-Mulindwa, D, Kaku, M, Kilani, B, Kim, E, Gazard, D, Klugman, K, Klutts, S, Kluytmans, J, Kollef, M, Koulenti, D, Kresken, M, Lacoin, F, Lajonchere, J, Landgraf, N, Larroussinie, G, Laterre, P, Lavenaire, A, Lavigne, T, Laxminarayan, R, Le, T, Leblanc-Jouffre, F, Lee, N, Lehiani, O, Lelouet, H, Lemanach-Kergueris, F, Lepape, A, Leroy, J, Lescure, X, Levy, M, Levy-Hara, G, Lin, L, Lipman, J, Livartowski, J, Looke, D, Cardozo, F, Medrano, F, Lotthe, A, Lucet, J, Lupande, D, Madec, J, Mainardi, J, Maiylagan, S, Mancebo, J, Mansour-Adeoti, F, Maravi, E, Marchou, B, Marciniuk, D, Marshall, J, Martin, C, Martin, D, Martinez-Martinez, L, Martinot, A, Maseda, E, Matamis, D, Matheron, S, Matos, R, Matthews, M, May, T, Mayet, T, Mcgowan, J, Mehtar, S, Teles, J, Mendelson, M, Michelet, C, Mifsud, A, Mikaszewska-Sokolewicz, M, Minion, J, Miquel, C, Mira, J, Miro, J, Misset, B, Monot, J, Montravers, P, Mootien, J, Moreno, R, Morris, A, Moulin, G, Mourlan, C, Mouthon, G, Mowafy, W, Muhl, E, Muruganathan, A, Mushira, E, N'Doye, B, Nana, A, Niederman, M, Nitenberg, G, Nordman, P, Novira, A, Nowak, C, Okeke, I, Olaechea, P, Omar, A, Opal, S, Leyba, C, Oudega, B, Oziol, E, Page, B, Paiva, J, Palmer, L, Palomar-Martinez, M, Parneix, P, de la Garanderie, D, Perencevich, E, Perl, T, Perronne, C, Peters, G, Peters, M, Peyramond, D, Philippart, F, Pittet, D, Pittet, J, Plesiat, P, Pletz, M, Ploy, M, Pospisil, F, Pouedras, P, Poulakou, G, Poursinoff, A, Pronovost, P, Pulcini, C, Puoti, M, Puvanendiram, S, Quintel, M, Rabaud, C, Rambaud, C, Ramos, H, Rassla, O, Raymond, J, Regnier, B, Reinhart, K, Condomines, J, Revil, J, Riche, A, Richman, P, Richmann, R, Rodriguez, V, Rodriguez-Bano, J, Romain, O, Romand, K, Rossines, E, Rothan-Tondeur, M, Rousselot, J, Rubinstein, E, Rudnov, V, Saini, N, Salmon, D, Salomao, R, Garcia, M, Santos-Bouza, A, Saux, M, Savey, A, Saxinger, L, Schlemmer, B, Schmit, J, Schneider, D, Schoemaker, J, Singh, S, Sole-Violan, J, Soto, S, Stahl, J, Stoclin, A, Tabah, A, Tabut, J, Tambyah, P, Tamion, F, Tarr, P, Tattevin, P, Tenover, F, Terzi, N, Lecompte, M, Theodore, J, Thevenin, D, Thevenot, P, Thiriet, L, Thompson, C, Thurn, J, Tillotson, G, Tiouiri, H, Torres, A, Tremolieres, F, Troadec, M, Umar, R, Upham, G, Urban, C, Vaarten, J, Valla, D, Van Der Mee-Marquet, N, Van der Meer, J, Van Der Poll, T, Vancel, J, Vanhems, P, Varin, R, Varon, E, Vaughan, D, Veilly, M, Vijayakumar, K, Villanueva, A, Vincent, J, Vitrat, V, Voss, A, Wachter, R, Walsh, T, Wark, P, Waterer, G, Wegener, H, Weinbreck, P, Weinstein, R, Weissman, S, Wiener-Kronish, J, Wilmer, A, Wyplosz, B, Yacoub-Agha, I, Young, M, Yusuf, I, Zein, E, Zhanel, G, Zinner, S, Zoungrana, J, Zubareva, N, Carlet J., Aaron L., Abassi M. S., Abbo L., Aboderin O., Abraham E., Abroug F., Acar J., Achour W., Adachi J., Al-Abri S., Al-Mousa H., Albaya-Moreno A., Alberti C., Alfandari S., Alnimr A., Aranda C. A., de Lerma F. A., Amer F., Andremont A., Angoulvant F., Anguill M., Antonelli M., Antoniadou E., Arlet G., Armaganidis A., Arnera A., Artigas A., Attali C., Auber F., Aubert J. -P., Augereau B., Aupee M., Bahri O., Ballereau F., Bapt G., Baquero F., Barkhan T., Barouti O., Barthelemy M. -A., Barton G., Bastoni D., Baussier M., Bavestrello L., Beger B., Benenson S., Bensalem F., Beraud G., Bergheau F., Bernard G., Berthelot P., Bertrand X., Beuhorry-Sassus F., Beuret P., Billington J., Birge J., Biscardi S., Blanch L., Blanchard H., Bleck T., Blondeau J., Blot F., Borgey F., Bousquet-Melou A., Brami J., Brard C., Bretagne S., Bretonniere C., Brink A., Brown S., Bruant-Rodier C., Brun-Buisson C., Bruneel F., de Carvalho F. B., Buhot C., Bukharie H., Cabie A., Calandra T., Caniaux I., Canica M., Canton R., Carenco P., Carlet C., Carlet F., Carlet R., Cars O., Cassiano-Neves M., Castan B., Castellan V., Cazenave-Roblot F., Ceretti A. -M., Chakarian J. -C., Chalumeau-Lemoine L., Chandy J., Chanfreau B., Chastre J., Chausset R., Chavanet P., Cheadle W., Chiche J. -D., Chidiac C., Chosidow O., Chueca N., Cohen J., Cohen R., Collignon P., Collot F., Coloby P., Conly J., Cordero C., Cordonnier C., Corso A., Cosgrove S., Courcol R., Crane S., Craven D., Crespin A., Cyrillo M., Danin P. -E., Waele J. D., Dellamonica P., Patchen Dellinger E., Dellinger P., Delmont J., Denes E., Dimopoulos G., Drekonja D., Mansilla A. D., Druais P. -L., Dufour-Pierrat S., Dumartin C., Dunser M., Dupont M., Durlach R., Dyar O., Echaniz G., Edelstein P., Eggimann P., Elghonemi M., Elmdaghri N., Elsaid R., Elsokari R., Engelhard D., Fabry J., Farmer C., Fernandez J., Finfer S., Finn P., Fjeldsted K., Floret D., Flozaro F., Foegle J., Forceville X., Fournier S., Frachon I., Friedrich A., Funuel P., Gaillard D., Gaillat J., Galperine T., Gambarotto K., Garo B., Garrouste-Orgeas M., Gastemeier P., Gauchot J. -Y., Gauzit R., Gavazzi G., Gazagne L., Gerberding J., Ghafur A., Giamarellos-Bourboulis E., Giamarellou E., Giard M., Gilchrist M., Gilquin J., Gilsanz F., Gniadkowski M., Gogos C., Goldman D., Gordon F., Gottlieb T., Gould I., Gouveia J., Grant J., Grason L., Greder A., Grundman H., Guaguere E., Gueroult-Locher G., Guery B., Guidet B., Guignabert C., Gupta P., Gupta S., Gurjar M., Guzman M., Hajjar J., Hammad N., Hammerum A., Hanberger H., Hanke R., Harbarth S., Harel A., Heisbourg E., Hermes I., Hermet J. -P., Hirschel B., Hoen B., Hollis A., Honghong X., Hooper D., Horcajada J. P., Housset B., Hryniewicz W., Hsu L. Y., Huang S., Hughes J., Hunault J. -L., Jakobsen L., Jalil N., Jansens H., Jarlier V., Jarvis W., Jean D., Jereb M., Johnson J., Joly-Guillou M. -L., Jonquet O., Kac G., Kaddu-Mulindwa D., Kaku M., Kilani B., Kim E. -C., Gazard D. K., Klugman K., Klutts S., Kluytmans J., Kollef M., Koulenti D., Kresken M., Lacoin F., Lajonchere J. -P., Landgraf N., Larroussinie G., Laterre P. -F., Lavenaire A. -M., Lavigne T., Laxminarayan R., Le T. A. T., Leblanc-Jouffre F., Lee N. Y., Lehiani O., Lelouet H., Lemanach-Kergueris F., Lepape A., Leroy J., Lescure X., Levy M., Levy-Hara G., Lin L. M., Lipman J., Livartowski J., Looke D., Cardozo F. L. L., Medrano F. L., Lotthe A., Lucet J. C., Lupande D., Madec J. -Y., Mainardi J. -L., Maiylagan S., Mancebo J., Mansour-Adeoti F., Maravi E., Marchou B., Marciniuk D., Marshall J., Martin C., Martin D., Martinez-Martinez L., Martinot A., Maseda E., Matamis D., Matheron S., Matos R., Matthews M., May T., Mayet T., McGowan J., Mehtar S., Teles J. M. M., Mendelson M., Michelet C., Mifsud A., Mikaszewska-Sokolewicz M., Minion J., Miquel C., Mira J. -P., Miro J., Misset B., Monot J. -J., Montravers P., Mootien J., Moreno R., Morris A., Moulin G., Mourlan C., Mouthon G., Mowafy W., Muhl E., Muruganathan A., Mushira E., N'Doye B., Nana A., Niederman M., Nitenberg G., Nordman P., Novira A., Nowak C., Okeke I., Olaechea P. M., Omar A., Opal S., Leyba C. O., Oudega B., Oziol E., Page B., Paiva J. A., Palmer L., Palomar-Martinez M., Parneix P., de la Garanderie D. P., Perencevich E., Perl T., Perronne C., Peters G., Peters M., Peyramond D., Philippart F., Pittet D., Pittet J. -F., Plesiat P., Pletz M., Ploy M. -C., Pospisil F., Pouedras P., Poulakou G., Poursinoff A., Pronovost P., Pulcini C., Puoti M., Puvanendiram S., Quintel M., Rabaud C., Rambaud C., Ramos H., Rassla O., Raymond J., Regnier B., Reinhart K., Condomines J. R., Revil J. -C., Riche A., Richman P., Richmann R., Rodriguez V., Rodriguez-Bano J., Romain O., Romand K., Rossines E., Rothan-Tondeur M. I., Rousselot J. -F., Rubinstein E., Rudnov V., Saini N., Salmon D., Salomao R., Garcia M. S., Santos-Bouza A., Saux M. -C., Savey A., Saxinger L., Schlemmer B., Schmit J. -L., Schneider D., Schoemaker J., Singh S., Sole-Violan J., Soto S., Stahl J. -P., Stoclin A., Tabah A., Tabut J. -P., Tambyah P. A., Tamion F., Tarr P., Tattevin P., Tenover F., Terzi N., Lecompte M. T., Theodore J., Thevenin D., Thevenot P., Thiriet L., Thompson C., Thurn J., Tillotson G., Tiouiri H., Torres A., Tremolieres F., Troadec M., Umar R., Upham G., Urban C., Vaarten J., Valla D., Van Der Mee-Marquet N., Van der Meer J., Van Der Poll T., Vancel J., Vanhems P., Varin R., Varon E., Vaughan D., Veilly M., Vijayakumar K., Villanueva A., Vincent J. -L., Vitrat V., Voss A., Wachter R., Walsh T., Wark P., Waterer G., Wegener H. C., Weinbreck P., Weinstein R., Weissman S., Wiener-Kronish J., Wilmer A., Wyplosz B., Yacoub-Agha I., Young M., Yusuf I., Zein E., Zhanel G., Zinner S., Zoungrana J., Zubareva N., Carlet, J, Aaron, L, Abassi, M, Abbo, L, Aboderin, O, Abraham, E, Abroug, F, Acar, J, Achour, W, Adachi, J, Al-Abri, S, Al-Mousa, H, Albaya-Moreno, A, Alberti, C, Alfandari, S, Alnimr, A, Aranda, C, de Lerma, F, Amer, F, Andremont, A, Angoulvant, F, Anguill, M, Antonelli, M, Antoniadou, E, Arlet, G, Armaganidis, A, Arnera, A, Artigas, A, Attali, C, Auber, F, Aubert, J, Augereau, B, Aupee, M, Bahri, O, Ballereau, F, Bapt, G, Baquero, F, Barkhan, T, Barouti, O, Barthelemy, M, Barton, G, Bastoni, D, Baussier, M, Bavestrello, L, Beger, B, Benenson, S, Bensalem, F, Beraud, G, Bergheau, F, Bernard, G, Berthelot, P, Bertrand, X, Beuhorry-Sassus, F, Beuret, P, Billington, J, Birge, J, Biscardi, S, Blanch, L, Blanchard, H, Bleck, T, Blondeau, J, Blot, F, Borgey, F, Bousquet-Melou, A, Brami, J, Brard, C, Bretagne, S, Bretonniere, C, Brink, A, Brown, S, Bruant-Rodier, C, Brun-Buisson, C, Bruneel, F, de Carvalho, F, Buhot, C, Bukharie, H, Cabie, A, Calandra, T, Caniaux, I, Canica, M, Canton, R, Carenco, P, Carlet, C, Carlet, F, Carlet, R, Cars, O, Cassiano-Neves, M, Castan, B, Castellan, V, Cazenave-Roblot, F, Ceretti, A, Chakarian, J, Chalumeau-Lemoine, L, Chandy, J, Chanfreau, B, Chastre, J, Chausset, R, Chavanet, P, Cheadle, W, Chiche, J, Chidiac, C, Chosidow, O, Chueca, N, Cohen, J, Cohen, R, Collignon, P, Collot, F, Coloby, P, Conly, J, Cordero, C, Cordonnier, C, Corso, A, Cosgrove, S, Courcol, R, Crane, S, Craven, D, Crespin, A, Cyrillo, M, Danin, P, Waele, J, Dellamonica, P, Patchen Dellinger, E, Dellinger, P, Delmont, J, Denes, E, Dimopoulos, G, Drekonja, D, Mansilla, A, Druais, P, Dufour-Pierrat, S, Dumartin, C, Dunser, M, Dupont, M, Durlach, R, Dyar, O, Echaniz, G, Edelstein, P, Eggimann, P, Elghonemi, M, Elmdaghri, N, Elsaid, R, Elsokari, R, Engelhard, D, Fabry, J, Farmer, C, Fernandez, J, Finfer, S, Finn, P, Fjeldsted, K, Floret, D, Flozaro, F, Foegle, J, Forceville, X, Fournier, S, Frachon, I, Friedrich, A, Funuel, P, Gaillard, D, Gaillat, J, Galperine, T, Gambarotto, K, Garo, B, Garrouste-Orgeas, M, Gastemeier, P, Gauchot, J, Gauzit, R, Gavazzi, G, Gazagne, L, Gerberding, J, Ghafur, A, Giamarellos-Bourboulis, E, Giamarellou, E, Giard, M, Gilchrist, M, Gilquin, J, Gilsanz, F, Gniadkowski, M, Gogos, C, Goldman, D, Gordon, F, Gottlieb, T, Gould, I, Gouveia, J, Grant, J, Grason, L, Greder, A, Grundman, H, Guaguere, E, Gueroult-Locher, G, Guery, B, Guidet, B, Guignabert, C, Gupta, P, Gupta, S, Gurjar, M, Guzman, M, Hajjar, J, Hammad, N, Hammerum, A, Hanberger, H, Hanke, R, Harbarth, S, Harel, A, Heisbourg, E, Hermes, I, Hermet, J, Hirschel, B, Hoen, B, Hollis, A, Honghong, X, Hooper, D, Horcajada, J, Housset, B, Hryniewicz, W, Hsu, L, Huang, S, Hughes, J, Hunault, J, Jakobsen, L, Jalil, N, Jansens, H, Jarlier, V, Jarvis, W, Jean, D, Jereb, M, Johnson, J, Joly-Guillou, M, Jonquet, O, Kac, G, Kaddu-Mulindwa, D, Kaku, M, Kilani, B, Kim, E, Gazard, D, Klugman, K, Klutts, S, Kluytmans, J, Kollef, M, Koulenti, D, Kresken, M, Lacoin, F, Lajonchere, J, Landgraf, N, Larroussinie, G, Laterre, P, Lavenaire, A, Lavigne, T, Laxminarayan, R, Le, T, Leblanc-Jouffre, F, Lee, N, Lehiani, O, Lelouet, H, Lemanach-Kergueris, F, Lepape, A, Leroy, J, Lescure, X, Levy, M, Levy-Hara, G, Lin, L, Lipman, J, Livartowski, J, Looke, D, Cardozo, F, Medrano, F, Lotthe, A, Lucet, J, Lupande, D, Madec, J, Mainardi, J, Maiylagan, S, Mancebo, J, Mansour-Adeoti, F, Maravi, E, Marchou, B, Marciniuk, D, Marshall, J, Martin, C, Martin, D, Martinez-Martinez, L, Martinot, A, Maseda, E, Matamis, D, Matheron, S, Matos, R, Matthews, M, May, T, Mayet, T, Mcgowan, J, Mehtar, S, Teles, J, Mendelson, M, Michelet, C, Mifsud, A, Mikaszewska-Sokolewicz, M, Minion, J, Miquel, C, Mira, J, Miro, J, Misset, B, Monot, J, Montravers, P, Mootien, J, Moreno, R, Morris, A, Moulin, G, Mourlan, C, Mouthon, G, Mowafy, W, Muhl, E, Muruganathan, A, Mushira, E, N'Doye, B, Nana, A, Niederman, M, Nitenberg, G, Nordman, P, Novira, A, Nowak, C, Okeke, I, Olaechea, P, Omar, A, Opal, S, Leyba, C, Oudega, B, Oziol, E, Page, B, Paiva, J, Palmer, L, Palomar-Martinez, M, Parneix, P, de la Garanderie, D, Perencevich, E, Perl, T, Perronne, C, Peters, G, Peters, M, Peyramond, D, Philippart, F, Pittet, D, Pittet, J, Plesiat, P, Pletz, M, Ploy, M, Pospisil, F, Pouedras, P, Poulakou, G, Poursinoff, A, Pronovost, P, Pulcini, C, Puoti, M, Puvanendiram, S, Quintel, M, Rabaud, C, Rambaud, C, Ramos, H, Rassla, O, Raymond, J, Regnier, B, Reinhart, K, Condomines, J, Revil, J, Riche, A, Richman, P, Richmann, R, Rodriguez, V, Rodriguez-Bano, J, Romain, O, Romand, K, Rossines, E, Rothan-Tondeur, M, Rousselot, J, Rubinstein, E, Rudnov, V, Saini, N, Salmon, D, Salomao, R, Garcia, M, Santos-Bouza, A, Saux, M, Savey, A, Saxinger, L, Schlemmer, B, Schmit, J, Schneider, D, Schoemaker, J, Singh, S, Sole-Violan, J, Soto, S, Stahl, J, Stoclin, A, Tabah, A, Tabut, J, Tambyah, P, Tamion, F, Tarr, P, Tattevin, P, Tenover, F, Terzi, N, Lecompte, M, Theodore, J, Thevenin, D, Thevenot, P, Thiriet, L, Thompson, C, Thurn, J, Tillotson, G, Tiouiri, H, Torres, A, Tremolieres, F, Troadec, M, Umar, R, Upham, G, Urban, C, Vaarten, J, Valla, D, Van Der Mee-Marquet, N, Van der Meer, J, Van Der Poll, T, Vancel, J, Vanhems, P, Varin, R, Varon, E, Vaughan, D, Veilly, M, Vijayakumar, K, Villanueva, A, Vincent, J, Vitrat, V, Voss, A, Wachter, R, Walsh, T, Wark, P, Waterer, G, Wegener, H, Weinbreck, P, Weinstein, R, Weissman, S, Wiener-Kronish, J, Wilmer, A, Wyplosz, B, Yacoub-Agha, I, Young, M, Yusuf, I, Zein, E, Zhanel, G, Zinner, S, Zoungrana, J, Zubareva, N, Carlet J., Aaron L., Abassi M. S., Abbo L., Aboderin O., Abraham E., Abroug F., Acar J., Achour W., Adachi J., Al-Abri S., Al-Mousa H., Albaya-Moreno A., Alberti C., Alfandari S., Alnimr A., Aranda C. A., de Lerma F. A., Amer F., Andremont A., Angoulvant F., Anguill M., Antonelli M., Antoniadou E., Arlet G., Armaganidis A., Arnera A., Artigas A., Attali C., Auber F., Aubert J. -P., Augereau B., Aupee M., Bahri O., Ballereau F., Bapt G., Baquero F., Barkhan T., Barouti O., Barthelemy M. -A., Barton G., Bastoni D., Baussier M., Bavestrello L., Beger B., Benenson S., Bensalem F., Beraud G., Bergheau F., Bernard G., Berthelot P., Bertrand X., Beuhorry-Sassus F., Beuret P., Billington J., Birge J., Biscardi S., Blanch L., Blanchard H., Bleck T., Blondeau J., Blot F., Borgey F., Bousquet-Melou A., Brami J., Brard C., Bretagne S., Bretonniere C., Brink A., Brown S., Bruant-Rodier C., Brun-Buisson C., Bruneel F., de Carvalho F. B., Buhot C., Bukharie H., Cabie A., Calandra T., Caniaux I., Canica M., Canton R., Carenco P., Carlet C., Carlet F., Carlet R., Cars O., Cassiano-Neves M., Castan B., Castellan V., Cazenave-Roblot F., Ceretti A. -M., Chakarian J. -C., Chalumeau-Lemoine L., Chandy J., Chanfreau B., Chastre J., Chausset R., Chavanet P., Cheadle W., Chiche J. -D., Chidiac C., Chosidow O., Chueca N., Cohen J., Cohen R., Collignon P., Collot F., Coloby P., Conly J., Cordero C., Cordonnier C., Corso A., Cosgrove S., Courcol R., Crane S., Craven D., Crespin A., Cyrillo M., Danin P. -E., Waele J. D., Dellamonica P., Patchen Dellinger E., Dellinger P., Delmont J., Denes E., Dimopoulos G., Drekonja D., Mansilla A. D., Druais P. -L., Dufour-Pierrat S., Dumartin C., Dunser M., Dupont M., Durlach R., Dyar O., Echaniz G., Edelstein P., Eggimann P., Elghonemi M., Elmdaghri N., Elsaid R., Elsokari R., Engelhard D., Fabry J., Farmer C., Fernandez J., Finfer S., Finn P., Fjeldsted K., Floret D., Flozaro F., Foegle J., Forceville X., Fournier S., Frachon I., Friedrich A., Funuel P., Gaillard D., Gaillat J., Galperine T., Gambarotto K., Garo B., Garrouste-Orgeas M., Gastemeier P., Gauchot J. -Y., Gauzit R., Gavazzi G., Gazagne L., Gerberding J., Ghafur A., Giamarellos-Bourboulis E., Giamarellou E., Giard M., Gilchrist M., Gilquin J., Gilsanz F., Gniadkowski M., Gogos C., Goldman D., Gordon F., Gottlieb T., Gould I., Gouveia J., Grant J., Grason L., Greder A., Grundman H., Guaguere E., Gueroult-Locher G., Guery B., Guidet B., Guignabert C., Gupta P., Gupta S., Gurjar M., Guzman M., Hajjar J., Hammad N., Hammerum A., Hanberger H., Hanke R., Harbarth S., Harel A., Heisbourg E., Hermes I., Hermet J. -P., Hirschel B., Hoen B., Hollis A., Honghong X., Hooper D., Horcajada J. P., Housset B., Hryniewicz W., Hsu L. Y., Huang S., Hughes J., Hunault J. -L., Jakobsen L., Jalil N., Jansens H., Jarlier V., Jarvis W., Jean D., Jereb M., Johnson J., Joly-Guillou M. -L., Jonquet O., Kac G., Kaddu-Mulindwa D., Kaku M., Kilani B., Kim E. -C., Gazard D. K., Klugman K., Klutts S., Kluytmans J., Kollef M., Koulenti D., Kresken M., Lacoin F., Lajonchere J. -P., Landgraf N., Larroussinie G., Laterre P. -F., Lavenaire A. -M., Lavigne T., Laxminarayan R., Le T. A. T., Leblanc-Jouffre F., Lee N. Y., Lehiani O., Lelouet H., Lemanach-Kergueris F., Lepape A., Leroy J., Lescure X., Levy M., Levy-Hara G., Lin L. M., Lipman J., Livartowski J., Looke D., Cardozo F. L. L., Medrano F. L., Lotthe A., Lucet J. C., Lupande D., Madec J. -Y., Mainardi J. -L., Maiylagan S., Mancebo J., Mansour-Adeoti F., Maravi E., Marchou B., Marciniuk D., Marshall J., Martin C., Martin D., Martinez-Martinez L., Martinot A., Maseda E., Matamis D., Matheron S., Matos R., Matthews M., May T., Mayet T., McGowan J., Mehtar S., Teles J. M. M., Mendelson M., Michelet C., Mifsud A., Mikaszewska-Sokolewicz M., Minion J., Miquel C., Mira J. -P., Miro J., Misset B., Monot J. -J., Montravers P., Mootien J., Moreno R., Morris A., Moulin G., Mourlan C., Mouthon G., Mowafy W., Muhl E., Muruganathan A., Mushira E., N'Doye B., Nana A., Niederman M., Nitenberg G., Nordman P., Novira A., Nowak C., Okeke I., Olaechea P. M., Omar A., Opal S., Leyba C. O., Oudega B., Oziol E., Page B., Paiva J. A., Palmer L., Palomar-Martinez M., Parneix P., de la Garanderie D. P., Perencevich E., Perl T., Perronne C., Peters G., Peters M., Peyramond D., Philippart F., Pittet D., Pittet J. -F., Plesiat P., Pletz M., Ploy M. -C., Pospisil F., Pouedras P., Poulakou G., Poursinoff A., Pronovost P., Pulcini C., Puoti M., Puvanendiram S., Quintel M., Rabaud C., Rambaud C., Ramos H., Rassla O., Raymond J., Regnier B., Reinhart K., Condomines J. R., Revil J. -C., Riche A., Richman P., Richmann R., Rodriguez V., Rodriguez-Bano J., Romain O., Romand K., Rossines E., Rothan-Tondeur M. I., Rousselot J. -F., Rubinstein E., Rudnov V., Saini N., Salmon D., Salomao R., Garcia M. S., Santos-Bouza A., Saux M. -C., Savey A., Saxinger L., Schlemmer B., Schmit J. -L., Schneider D., Schoemaker J., Singh S., Sole-Violan J., Soto S., Stahl J. -P., Stoclin A., Tabah A., Tabut J. -P., Tambyah P. A., Tamion F., Tarr P., Tattevin P., Tenover F., Terzi N., Lecompte M. T., Theodore J., Thevenin D., Thevenot P., Thiriet L., Thompson C., Thurn J., Tillotson G., Tiouiri H., Torres A., Tremolieres F., Troadec M., Umar R., Upham G., Urban C., Vaarten J., Valla D., Van Der Mee-Marquet N., Van der Meer J., Van Der Poll T., Vancel J., Vanhems P., Varin R., Varon E., Vaughan D., Veilly M., Vijayakumar K., Villanueva A., Vincent J. -L., Vitrat V., Voss A., Wachter R., Walsh T., Wark P., Waterer G., Wegener H. C., Weinbreck P., Weinstein R., Weissman S., Wiener-Kronish J., Wilmer A., Wyplosz B., Yacoub-Agha I., Young M., Yusuf I., Zein E., Zhanel G., Zinner S., Zoungrana J., and Zubareva N.

Abstract

We must change how antibiotics are used and adopt proactive strategies, similar to those used to save endangered species. Preservation of the efficacy of antibiotics and to stabilization of antibiotic-susceptible bacterial ecosystems should be global goals. (C) 2014 Elsevier Espana, S.L.U. and SEMICYUC. All rights reserved.

Published
2015

19. The worldwide antibiotic resistance and prescribing in european children (ARPEC) point prevalence survey: Developing hospital-quality indicators of antibiotic prescribing for children

Author

Versporten, A. Bielicki, J. Drapier, N. Sharland, M. Goossens, H. Calle, G.M. Clark, J. Cooper, C. Blyth, C.C. Francis, J.R. Alsalman, J. Jansens, H. Mahieu, L. Van Rossom, P. Vandewal, W. Lepage, P. Blumental, S. Briquet, C. Robbrecht, D. Maton, P. Gabriels, P. Rubic, Z. Kovacevic, T. Nielsen, J.P. Petersen, J.R. Poorisrisak, P. Jensen, L.H. Laan, M. Tamm, E. Matsinen, M. Rummukainen, M.-L. Gajdos, V. Olivier, R. Le Maréchal, F. Martinot, A. Prot-Labarthe, S. Lorrot, M. Orbach, D. Pagava, K. Hufnagel, M. Knuf, M. Schlag, S.A.A. Liese, J. Renner, L. Enimil, A. Awunyo, M. Syridou, G. Spyridis, N. Critselis, E. Kouni, S. Mougkou, K. Ladomenou, F. Gkentzi, D. Iosifidis, E. Roilides, E. Sahu, S. Murki, S. Malviya, M. Kalavalapalli, D.B. Singh, S. Singhal, T. Garg, G. Garg, P. Kler, N. Soltani, J. Jafarpour, Z. Pouladfar, G. Nicolini, G. Montagnani, C. Galli, L. Esposito, S. Vecchio, A.L. Dona', D. Giaquinto, C. Borgia, E. D'Argenio, P. De Luca, M. Centenari, C. Raka, L. Omar, A. Al-Mousa, H. Mozgis, D. Sviestina, I. Burokiene, S. Usonis, V. Tavchioska, G. Hargadon-Lowe, A. Zarb, P. Borg, M.A. González Lozano, C.A. Castañon, P.Z. Cancino, M.E. McCullagh, B. McCorry, A. Gormley, C. Al Maskari, Z. Al-Jardani, A. Pluta, M. Rodrigues, F. Brett, A. Esteves, I. Marques, L. AlAjmi, J.A. Cambrea, S.C. Rashed, A.N. Al Azmi, A.A.M. Chan, S.M. Isa, M.S. Najdenov, P. Čižman, M. Unuk, S. Finlayson, H. Dramowski, A. Maté-Cano, I. Soto, B. Calvo, C. Santiago, B. Saavedra-Lozano, J. Bustinza, A. Escosa-García, L. Ureta, N. Tagarro, A. Barrero, P.T. Rincon-Lopez, E.M. Abubakar, I. Aston, J. Heginbothom, M. Satodia, P. Garbash, M. Johnson, A. Sharpe, D. Barton, C. Menson, E. Arenas-Lopez, S. Luck, S. Doerholt, K. McMaster, P. Caldwell, N.A. Lunn, A. Drysdale, S.B. Howe, R. Scorrer, T. Gahleitner, F. Gupta, R. Nash, C. Alexander, J. Raman, M. Bell, E. Rajagopal, V. Kohlhoff, S. Cox, E. Zaoutis, T. ARPEC project group

Abstract

Objectives: Previously, web-based tools for cross-sectional antimicrobial point prevalence surveys (PPSs) have been used in adults to develop indicators of quality improvement. We aimed to determine the feasibility of developing similar quality indicators of improved antimicrobial prescribing focusing specifically on hospitalized neonates and children worldwide. Methods: A standardized antimicrobial PPS method was employed. Included were all inpatient children and neonates receiving an antimicrobial at 8:00 am on the day of the PPS. Denominators included the total number of inpatients. A web-based application was used for data entry, validation and reporting. We analysed 2012 data from 226 hospitals (H) in 41 countries (C) from Europe (174H; 24C), Africa (6H; 4C), Asia (25H; 8C), Australia (6H), Latin America (11H; 3C) and North America (4H). Results: Of 17 693 admissions, 6499 (36.7%) inpatients received at least one antimicrobial, but this varied considerably between wards and regions. Potential indicators included very high broad-spectrum antibiotic prescribing in children of mainly ceftriaxone (ranked first in Eastern Europe, 31.3%; Asia, 13.0%; Southern Europe, 9.8%), cefepime (ranked third in North America, 7.8%) and meropenem (ranked first in Latin America, 13.1%). The survey identified worryingly high use of critically important antibiotics for hospital-acquired infections in neonates (34.9%; range from 14.2% in Africa to 68.0% in Latin America) compared with children (28.3%; range from 14.5% in Africa to 48.9% in Latin America). Parenteral administration was very common among children in Asia (88%), Latin America (81%) and Europe (67%). Documentation of the reasons for antibiotic prescribing was lowest in Latin America (52%). Prolonged surgical prophylaxis rates ranged from 78% (Europe) to 84% (Latin America). Conclusions: Simple web-based PPS tools provide a feasible method to identify areas for improvement of antibiotic use, to set benchmarks and to monitor future interventions in hospitalized neonates and children. To our knowledge, this study has derived the first global quality indicators for antibiotic use in hospitalized neonates and children. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved.

Published
2016

20. Variation in paediatric hospital antibiotic guidelines in Europe

Author

Spyridis, N. Syridou, G. Goossens, H. Versporten, A. Kopsidas, J. Kourlaba, G. Bielicki, J. Drapier, N. Zaoutis, T. Tsolia, M. Sharland, M. Vergison, A. Léon, V. Delestrait, M. Huza, C. Lepage, P. Mahieu, L. Boy, T. Jansens, H. Van Der Linden, D. Briquet, C. Allegaert, K. Smits, A. Gabriels, P. Vuye, A. Lutsar, I. Tamm, E. Larionova, A. Laan, D. Orbach, M. Lorrot, M. Angoulvant, F. Prot-Labarthe, S. Dubos, F. Lagree, M. Hufnagel, M. Schuster, K. Henneke, P. Roilides, E. Iosifidis, E. Corovessi, V. Michos, A. Galanakis, E. Gkentzi, D. Giacquinto, C. Longo, G. Dona, D. Mion, T. D'Argenio, P. Degli, M.L.C. De Luca, M. Ciliento, G. Esposito, S. Danieli, E. Montinaro, V. Tenconi, R. Nicolini, G. Sviestina, C.I.M. Pavare, J. Rasnaca, K. Gardovska, D. Usonis, V. Grope, I. Gurksniene, V. Eidukaite, A. Biver, A. Brett, A. Esteves, I. Cambrea, S.C. Craiu, M. Tomescu, E. Cizman, M. Babnik, J. Kenda, R. Vidmar, I. Nunez-Cuadros, E. Rojo, P. Lopez-Varela, E. Ureta, N. Perez-Lopez, A. Mosqueda, R. Orta, L. Santos, M. Navarro, M. Santiago, B. Hernandez-Sampelaya, T. Saavedra, J. Pineiro, R. Torel, P. Cano, I.M. Baumann, P. Berger, C. Menson, E. Botgros, A. Doerholt, K. Drysdale, S. Makwana, N. McCorry, A. Garbash, E.M. Chetcutiganado, C. McLeod, M. Caldwell, N. Nash, C. McCullagh, B. Sharpe, D. Tweddell, L. Liese, J.G. Aston, J. Gallagher, A. Satodia, P. Howard-Smith, N. Korinteli, I. Tavchioska, G. Jensen, L. Trethon, A. Unuk, S. Childs, N. Canlas, J.

Abstract

Objective: To assess the availability and source of guidelines for common infections in European paediatric hospitals and determine their content and characteristics. Design: Participating hospitals completed an online questionnaire on the availability and characteristics of antibiotic prescribing guidelines and on empirical antibiotic treatment including duration of therapy for 5 common infection syndromes: respiratory tract, urinary tract, skin and soft tissue, osteoarticular and sepsis in neonates and children. Results: 84 hospitals from 19 European countries participated in the survey of which 74 confirmed the existence of guidelines. Complete guidelines (existing guidelines for all requested infection syndromes) were reported by 20% of hospitals and the majority (71%) used a range of different sources. Guidelines most commonly available were those for urinary tract infection (UTI) (74%), neonatal sepsis (71%) and sepsis in children (65%). Penicillin and amoxicillin were the antibiotics most commonly recommended for respiratory tract infections (RTIs) (up to 76%), cephalosporin for UTI (up to 50%) and for skin and soft tissue infection (SSTI) and bone infection (20% and 30%, respectively). Antistaphylococcal penicillins were recommended for SSTIs and bone infections in 43% and 36%, respectively. Recommendations for neonatal sepsis included 20 different antibiotic combinations. Duration of therapy guidelines was mostly available for RTI and UTI (82%). A third of hospitals with guidelines for sepsis provided recommendations for length of therapy. Conclusions: Comprehensive antibiotic guideline recommendations are generally lacking from European paediatric hospitals. We documented multiple antibiotics and combinations for most infections. Considerable improvement in the quality of guidelines and their evidence base is required, linking empirical therapy to resistance rates.

Published
2016

21. The worldwide antibiotic resistance and prescribing in european children (ARPEC) point prevalence survey: Developing hospital-quality indicators of antibiotic prescribing for children.

Author

Soltani J., Kovacevic T., Nielsen J.P., Petersen J.R., Poorisrisak P., Jensen L.H., Laan M., Tamm E., Matsinen M., Rummukainen M.-L., Gajdos V., Olivier R., Le Marechal F., Martinot A., Prot-Labarthe S., Lorrot M., Orbach D., Pagava K., Hufnagel M., Knuf M., Schlag S.A.A., Liese J., Renner L., Enimil A., Awunyo M., Syridou G., Spyridis N., Critselis E., Kouni S., Mougkou K., Ladomenou F., Gkentzi D., Iosifidis E., Roilides E., Sahu S., Murki S., Malviya M., Kalavalapalli D.B., Singh S., Singhal T., Garg G., Garg P., Kler N., Jafarpour Z., Pouladfar G., Nicolini G., Montagnani C., Galli L., Esposito S., Vecchio A.L., Dona' D., Giaquinto C., Borgia E., D'Argenio P., De Luca M., Centenari C., Raka L., Omar A., Al-Mousa H., Mozgis D., Sviestina I., Burokiene S., Usonis V., Tavchioska G., Hargadon-Lowe A., Zarb P., Borg M.A., Gonzalez Lozano C.A., Castanon P.Z., Cancino M.E., McCullagh B., McCorry A., Gormley C., Al Maskari Z., Al-Jardani A., Pluta M., Rodrigues F., Brett A., Esteves I., Marques L., AlAjmi J.A., Cambrea S.C., Rashed A.N., Al Azmi A.A.M., Chan S.M., Isa M.S., Najdenov P., Cizman M., Unuk S., Finlayson H., Dramowski A., Mate-Cano I., Soto B., Calvo C., Santiago B., Saavedra-Lozano J., Bustinza A., Escosa-Garcia L., Ureta N., Tagarro A., Barrero P.T., Rincon-Lopez E.M., Abubakar I., Aston J., Heginbothom M., Satodia P., Garbash M., Johnson A., Sharpe D., Barton C., Menson E., Arenas-Lopez S., Luck S., Doerholt K., McMaster P., Caldwell N.A., Lunn A., Drysdale S.B., Howe R., Scorrer T., Gahleitner F., Gupta R., Nash C., Alexander J., Raman M., Bell E., Rajagopal V., Kohlhoff S., Cox E., Zaoutis T., Versporten A., Bielicki J., Drapier N., Sharland M., Goossens H., Calle G.M., Clark J., Cooper C., Blyth C.C., Francis J.R., Alsalman J., Jansens H., Mahieu L., Van Rossom P., Vandewal W., Lepage P., Blumental S., Briquet C., Robbrecht D., Maton P., Gabriels P., Rubic Z., Soltani J., Kovacevic T., Nielsen J.P., Petersen J.R., Poorisrisak P., Jensen L.H., Laan M., Tamm E., Matsinen M., Rummukainen M.-L., Gajdos V., Olivier R., Le Marechal F., Martinot A., Prot-Labarthe S., Lorrot M., Orbach D., Pagava K., Hufnagel M., Knuf M., Schlag S.A.A., Liese J., Renner L., Enimil A., Awunyo M., Syridou G., Spyridis N., Critselis E., Kouni S., Mougkou K., Ladomenou F., Gkentzi D., Iosifidis E., Roilides E., Sahu S., Murki S., Malviya M., Kalavalapalli D.B., Singh S., Singhal T., Garg G., Garg P., Kler N., Jafarpour Z., Pouladfar G., Nicolini G., Montagnani C., Galli L., Esposito S., Vecchio A.L., Dona' D., Giaquinto C., Borgia E., D'Argenio P., De Luca M., Centenari C., Raka L., Omar A., Al-Mousa H., Mozgis D., Sviestina I., Burokiene S., Usonis V., Tavchioska G., Hargadon-Lowe A., Zarb P., Borg M.A., Gonzalez Lozano C.A., Castanon P.Z., Cancino M.E., McCullagh B., McCorry A., Gormley C., Al Maskari Z., Al-Jardani A., Pluta M., Rodrigues F., Brett A., Esteves I., Marques L., AlAjmi J.A., Cambrea S.C., Rashed A.N., Al Azmi A.A.M., Chan S.M., Isa M.S., Najdenov P., Cizman M., Unuk S., Finlayson H., Dramowski A., Mate-Cano I., Soto B., Calvo C., Santiago B., Saavedra-Lozano J., Bustinza A., Escosa-Garcia L., Ureta N., Tagarro A., Barrero P.T., Rincon-Lopez E.M., Abubakar I., Aston J., Heginbothom M., Satodia P., Garbash M., Johnson A., Sharpe D., Barton C., Menson E., Arenas-Lopez S., Luck S., Doerholt K., McMaster P., Caldwell N.A., Lunn A., Drysdale S.B., Howe R., Scorrer T., Gahleitner F., Gupta R., Nash C., Alexander J., Raman M., Bell E., Rajagopal V., Kohlhoff S., Cox E., Zaoutis T., Versporten A., Bielicki J., Drapier N., Sharland M., Goossens H., Calle G.M., Clark J., Cooper C., Blyth C.C., Francis J.R., Alsalman J., Jansens H., Mahieu L., Van Rossom P., Vandewal W., Lepage P., Blumental S., Briquet C., Robbrecht D., Maton P., Gabriels P., and Rubic Z.

Abstract

Objectives: Previously, web-based tools for cross-sectional antimicrobial point prevalence surveys (PPSs) have been used in adults to develop indicators of quality improvement. We aimed to determine the feasibility of developing similar quality indicators of improved antimicrobial prescribing focusing specifically on hospitalized neonates and children worldwide. Method(s): A standardized antimicrobial PPS method was employed. Included were all inpatient children and neonates receiving an antimicrobial at 8:00 am on the day of the PPS. Denominators included the total number of inpatients. A web-based application was used for data entry, validation and reporting. We analysed 2012 data from 226 hospitals (H) in 41 countries (C) from Europe (174H; 24C), Africa (6H; 4C), Asia (25H; 8C), Australia (6H), Latin America (11H; 3C) and North America (4H). Result(s): Of 17 693 admissions, 6499 (36.7%) inpatients received at least one antimicrobial, but this varied considerably between wards and regions. Potential indicators included very high broad-spectrum antibiotic prescribing in children of mainly ceftriaxone (ranked first in Eastern Europe, 31.3%; Asia, 13.0%; Southern Europe, 9.8%), cefepime (ranked third in North America, 7.8%) and meropenem (ranked first in Latin America, 13.1%). The survey identified worryingly high use of critically important antibiotics for hospital-acquired infections in neonates (34.9%; range from 14.2% in Africa to 68.0% in Latin America) compared with children (28.3%; range from 14.5% in Africa to 48.9% in Latin America). Parenteral administration was very common among children in Asia (88%), Latin America (81%) and Europe (67%). Documentation of the reasons for antibiotic prescribing was lowest in Latin America (52%). Prolonged surgical prophylaxis rates ranged from 78% (Europe) to 84% (Latin America). Conclusion(s): Simple web-based PPS tools provide a feasible method to identify areas for improvement of antibiotic use, to set benchmarks and to

Published
2016

23. Altered CD4+ T cell immunity in nurses occupationally exposed to viral pathogens.

Author

Elias, G., Souquette, A., Heynderickx, S., De Meester, I., Jansens, H., Beutels, P., Van Damme, P., Smits, E., Thomas, P. G., Van Tendeloo, V., and Ogunjimi, B.

Subjects
T cells, HERPESVIRUSES, IMMUNE system, CYTOKINES, TETANUS toxin, NURSES, WORK environment
Abstract

Summary: Pathogen exposure, including but not limited to herpesviruses, moulds the shape of the immune system, both at a basal state and in response to immune challenge. However, little is known about the impact of high exposure to other viruses on baseline immune signatures and how the immune system copes with repetitive exposures to maintain a balanced functionality. Here we investigated baseline immune signatures, including detailed T cell phenotyping, antigen‐specific CD4+ and CD8+ T cell responses and cytokine profile in paediatric (PED) nurses, who have high occupational exposure to viral pathogens including varicella zoster virus (VZV) and respiratory viruses, and in neonatal intensive care unit (NICU) nurses, as a control group with infrequent occupational exposure. Our results show a lower CD4+ T cell response to two VZV proteins (IE62 and gE) and to tetanus toxoid (TT) in PED nurses who are cytomegalovirus (CMV)‐seronegative, compared to CMV‐seronegative NICU nurses, and that the decline might be more pronounced the more sustained the exposure. This decline might be due to an attrition of VZV‐ and TT‐specific T cells as a result of the continuous pressure on the CD4+ T cell compartment. Moreover, our data suggest that the distinct T cell phenotypes known to be associated with CMV‐seropositivity might be less prominent in PED nurses compared to NICU nurses, implying a plausible attenuating effect of occupational exposure on CMV‐associated immunosenescence. Overall, this pilot study reveals an impact of occupational exposure to viral pathogens on CD4+ T cell immunity and supports further investigation in a larger cohort. Nurses who are CMV‐naïve and occupationally exposed to viral pathogens show a lower CD4+ T‐cell response to varicella zoster virus and tetanus toxoid, and the decline may be more pronounced the more sustained the exposure is. Moreover, CMV‐induced T‐cell immunosenescence may be less prominent in occupationally exposed nurses, implying a plausible attenuating effect of such exposure. [ABSTRACT FROM AUTHOR]

Published
2018
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24. The antibiotic resistance and prescribing in European Children project: a neonatal and pediatric antimicrobial web-based point prevalence survey in 73 hospitals worldwide

Author

Versporten, A, Sharland, M, Bielicki, J, Drapier, N, Vankerckhoven, V, Goossens, H, ARPEC Project Group Members, Cooper, C, Lee, Ly, Whitehouse, J, Bryant, Pa, Haeusler, G, Curtis, N, Starr, M, Vergison, A, Léon, V, Delestrait, M, Huza, C, Lepage, P, Mahieu, L, Boiy, T, Jansens, H, Van der Linden, D, Briquet, C, Allegaert, K, Smits, A, Lutsar, I, Tamm, E, Larionova, A, Orbach, D, Lorrot, M, Angoulvant, F, Doit, C, Prot-Labarthe, S, Dubos, F, Lagree, M, Biscardi, S, Decobert, F, Hau, I, Madhi, F, Durrmeyer, X, Bojang, K, Abubakr, I, Okomo, U, Awe, R, Anderson, S, Akwara, I, Ideh, Rc, Pagava, K, Hufnagel, M, Schuster, K, Henneke, P, Enimil, A, Osei-Akoto, A, Nguah, Sb, Ansong, D, Iosifidis, E, Roilides, E, Spyridis, N, Syridou, G, Soltani, J, Soleimani, N, Nahedi, S, Khosravi, F, Pouladfar, G, Jafarpour, Z, Giacquinto, C, Longo, G, Donà, D, Mion, T, D'Argenio, P, Ciofi Degli Atti ML, De Luca, M, Ciliento, G, Esposito, S, Danieli, E, Montinaro, V, Tenconi, R, Centenari, C, Nicolini, G, Mozgis, D, Sviestina, I, Pavare, J, Rasnaca, K, Gardovska, D, Grope, I, Usonis, V, Gurksniene, V, Eidukaite, A, Biver, A, Bennett, A, O'Hare, B, Kennedy, N, Brett, A, Rodrigues, F, Esteves, I, Cambrea, Sc, Craiu, M, Tomescu, E, Al Shehri MA, Al Shahrani, D, Cizman, M, Babnik, J, Kenda, R, Vidmar, I, Finlayson, H, Rabie, H, Cotton, M, Dramowski, A, Rodrigo, C, Mendez, M, Rojo, P, López-Varela, E, Ureta, N, Mosqueda, R, Pérez-López, A, Orta, L, Santos, M, Navarro, M, Santiago, B, Hernández-Sampelayo, T, Saavedra, J, Bustinza, A, Gil, J, Valls, A, Santesteban, E, Baumann, P, Berger, C, Gifford, A, Menson, E, Botgros, A, Arenas-Lopez, S, Wade, P, Doerholt, K, Drysdale, Sb, Mcelnay, Jc, Kearney, Mp, Scott, Mg, Magee, Fa, Aldeyab, M, Heginbothom, M, Newland, Jg, Hedican, Eb, Shah, H, Stach, L, and Yu, D

Subjects
Microbiology (medical), Pediatrics, medicine.medical_specialty, medicine.drug_class, Antibiotics, MEDLINE, Drug resistance, Drug Prescriptions, point prevalence survey, antibiotic use, Antibiotic resistance, Intensive care, Drug Resistance, Bacterial, Medicine, Humans, Child, Electronic Data Processing, Internet, business.industry, Health services research, Antimicrobial, antimicrobial use, Confidence interval, Drug Utilization, Hospitals, Anti-Bacterial Agents, Europe, Infectious Diseases, Pediatrics, Perinatology and Child Health, surveillance, hospitalized children, Health Services Research, business, Public Health Administration
Abstract

Background The neonatal and pediatric antimicrobial point prevalence survey (PPS) of the Antibiotic Resistance and Prescribing in European Children project (http://www.arpecproject.eu/) aims to standardize a method for surveillance of antimicrobial use in children and neonates admitted to the hospital within Europe. This article describes the audit criteria used and reports overall country-specific proportions of antimicrobial use. An analytical review presents methodologies on antimicrobial use. Methods A 1-day PPS on antimicrobial use in hospitalized children was organized in September 2011, using a previously validated and standardized method. The survey included all inpatient pediatric and neonatal beds and identified all children receiving an antimicrobial treatment on the day of survey. Mandatory data were age, gender, (birth) weight, underlying diagnosis, antimicrobial agent, dose and indication for treatment. Data were entered through a web-based system for data-entry and reporting, based on the WebPPS program developed for the European Surveillance of Antimicrobial Consumption project. Results There were 2760 and 1565 pediatric versus 1154 and 589 neonatal inpatients reported among 50 European (n = 14 countries) and 23 non-European hospitals (n = 9 countries), respectively. Overall, antibiotic pediatric and neonatal use was significantly higher in non-European (43.8%; 95% confidence interval [CI]: 41.3-46.3% and 39.4%; 95% CI: 35.5-43.4%) compared with that in European hospitals (35.4; 95% CI: 33.6-37.2% and 21.8%; 95% CI: 19.4-24.2%). Proportions of antibiotic use were highest in hematology/oncology wards (61.3%; 95% CI: 56.2-66.4%) and pediatric intensive care units (55.8%; 95% CI: 50.3-61.3%). Conclusions An Antibiotic Resistance and Prescribing in European Children standardized web-based method for a 1-day PPS was successfully developed and conducted in 73 hospitals worldwide. It offers a simple, feasible and sustainable way of data collection that can be used globally.

Published
2013

25. A tropical diabetic foot

Author

Henckaerts, L., Naesens, R., Vlieghe, E., Jansens, H., Gielen, J., Ieven, M., and Moorkens, G.

Subjects
Treatment, Madurella mycetomi, Diabetes mellitus type 2, Case reports, Belgium, Foot, Diagnosis, Fungi, Osteomyelitis, Europe, West, Human medicine, Itraconazole, Management
Abstract

Foot infections area common problem and an important cause of morbidity in patients with diabetes. We report a patient with type 2 diabetes, presenting with a chronic foot wound resistant to standard care, in whom : the diagnosis of eumycetoma was made through histopathological examination of a bone biopsy specimen and confirmed by polymerase chain reaction (PCR). Diagnosis and treatment of eumycetoma are reviewed. Eumycetoma caused by Madurella mycetomatis is an uncommon cause of osteomyelitis in patients with diabetes in Europe, but should he considered in patients from endemic regions when (antibacterial) therapy fails.

Published
2012

30. Long-term epidemiology of bacterial susceptibility profiles in adults suffering from febrile neutropenia with hematologic malignancy after antibiotic change

Author

Mebis,Jeroen, Jansens,H, Minalu,G, Molenberghs,G, Schroyens,WA, Gadisseur,AP, van de Velde,A, Vrelust,I, Goossens,H, Berneman,ZN, Mebis,Jeroen, Jansens,H, Minalu,G, Molenberghs,G, Schroyens,WA, Gadisseur,AP, van de Velde,A, Vrelust,I, Goossens,H, and Berneman,ZN

Abstract

J Mebis1,2, H Jansens3, G Minalu4, G Molenberghs4, WA Schroyens1, AP Gadisseur1, A van de Velde1, I Vrelust1, H Goossens3, ZN Berneman11Division of Hematology, Antwerp University Hospital, Edegem, 2Division of Medical Oncology, Jessa Hospital, Hasselt, 3Division of Microbiology, Antwerp University Hospital, Edegem, 4Interuniversity Institute for Biostatistics and Statistical Bioinformatics, Hasselt University, Hasselt, BelgiumObjective: The aim of this study was to investigate the epidemiology and antibiotic ­susceptibility profiles of isolated bacterial organisms in relation to empiric treatment of neutropenic fever over a 15-year period.Methods: All patients with or at risk febrile neutropenia and treated in the hematology ward of the Antwerp University Hospital during 1994–2008 were prospectively included. Skin, blood, and urine cultures were taken. Oral quinolone prophylaxis was started in patients with neutropenia without fever. Empiric starting therapy consisted of amikacin in combination with cefepime.Results: A total of 3624 bacteria were isolated. The most common pathogens were coagulase-negative Staphylococci (46%), followed by Escherichia coli (25%), Enterobacteriaceae (15.6%), Staphylococcus aureus (7.2%), and Pseudomonas aeruginosa (3.8%). The balance between Gram-positive and Gram-negative bacteria remained stable, with a majority of Gram-positive bacteria. A shift from oxacillin-sensitive to oxacillin-resistant coagulase-negative Staphylococci was observed. Regarding susceptibility patterns, no vancomycin resistance was detected in coagulase-negative Staphylococci or in S. aureus. The E. coli susceptibility rates remained stable. However, 66% of bloodstream infections were ciprofloxacin-resistant. A reduced susceptibility of P. aeruginosa strains to meropenem was noticed.Conclusions: Improvement in antibiotic susceptibility of inducible Enterobacteriaceae ­following a switch of empiric antibiotic therapy was maintained 15 yea

Published
2010

31. Antibioticum formularium UZ Antwerpen

Author

Berneman, Zwi Nisan, Bossaert, Leo, Bruyneel, Paul, Demey, Hendrik, Goossens, Herman, Jansens, H., Mahieu, Ludo, Schrijvers, Dirk, Stappaerts, I., and Vaneerdeweg, Wouter

Published
1999

33. A series of five adult cases of respiratory syncytial virus-related acute respiratory distress syndrome.

Author

Robert D, Verbiest D, Demey H, Ieven M, Jansens H, Jorens PG, Robert, D, Verbiest, D, Demey, H, Ieven, M, Jansens, H, and Jorens, P G

Abstract

Respiratory syncytial virus is a common cause of respiratory tract disease in children, predominantly presenting with mild symptoms. We present five cases of respiratory syncytial virus infection of the lower respiratory tract in immunocompromised adults suffering from severe respiratory insufficiency leading to bilateral pneumonia and fulfilling the criteria for acute respiratory distress syndrome. Respiratory syncytial virus was cultured as the only pathogen in the bronchoalveolar lavage fluid in four of these patients. Despite various therapeutic interventions, only one patient survived. Respiratory syncytial virus was implicated as a direct cause of respiratory failure. Respiratory syncytial virus may be an underestimated cause of severe respiratory failure and acute respiratory distress syndrome in the immunocompromised adult admitted to the intensive care unit. [ABSTRACT FROM AUTHOR]

Published
2008
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42. Memory CD4+ T cell receptor repertoire data mining as a tool for identifying cytomegalovirus serostatus

Author

de Neuter, N, primary, Bartholomeus, E, additional, Elias, G, additional, Keersmaekers, N, additional, Suls, A, additional, Jansens, H, additional, Smits, E, additional, Hens, N, additional, Beutels, P, additional, Van Damme, P, additional, Mortier, G, additional, Van Tendeloo, V, additional, Laukens, K, additional, Meysman, P, additional, and Ogunjimi, B, additional

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43. Flemish consensus statement on the prevention, diagnosis and treatment of urinary tract infections in older nursing home residents.

Author

Langbeen J, Saegeman V, Heireman L, Magerman K, Jansens H, Van Kerkhoven D, Dhaeze W, De Lepeleire J, Latour K, Coenen I, Ho E, Vereecke D, Jouck D, Van Hoecke F, and Vogelaers D

Abstract

Background: Urinary tract infections (UTIs) are one of the most commonly reported infections in Belgian nursing home residents. In older adults, UTI diagnosis and management is complex, often leading to over-diagnosis and irrational antimicrobial use, stressing the need for a guideline approach., Objectives and Methods: A consensus statement on the prevention, diagnosis and treatment of UTIs in older adults residing in nursing homes was developed in a collaborative effort between the Flemish Hospital Outbreak Support Teams, the Flemish Agency for Care and Health, the Association of the Flemish Coordinating and Advising General Practitioners, the Belgian Association of Urology, the Belgian Society for Gerontology and Geriatrics and PhD researchers based on a combination of clinical expertise, (inter)national guidelines and peer-reviewed studies., Results: Optimizing fluid intake, appropriate toilet behaviour and posture, mobilization and local estrogen therapy in women are of proven value in UTI prevention, whereas the use of cranberry and probiotics is not to be advocated. The importance of avoiding bladder catheterization is stressed. In older nursing home residents, the diagnosis of UTIs remains challenging, mostly due to atypical systemic symptoms. A consensus diagnostic algorithm for UTI among residents with and without a urinary catheter was developed, including the presence of suggestive clinical symptoms and a positive urine culture. Urine dipsticks have a high negative but a low positive predictive value. C-reactive protein point-of-care testing is not recommended. Asymptomatic bacteriuria should not be screened for, in order to avoid unnecessary triggers for treatment. In cystitis, nitrofurantoin is the primary choice for treatment, with fosfomycin as an alternative; in prostatitis and uncomplicated pyelonephritis a fluoroquinolone is the advocated empirical antimicrobial.

Published
2024
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44. Unraveling the Immune Signature of Herpes Zoster: Insights Into the Pathophysiology and Human Leukocyte Antigen Risk Profile.

Author

Vandoren R, Boeren M, Schippers J, Bartholomeus E, Mullan K, Michels N, Aerts O, Leysen J, Bervoets A, Lambert J, Leuridan E, Wens J, Peeters K, Emonds MP, Jansens H, Casanova JL, Bastard P, Suls A, Van Tendeloo V, Ponsaerts P, Delputte P, Ogunjimi B, Laukens K, and Meysman P

Subjects
Humans, Aged, Male, Middle Aged, Genetic Predisposition to Disease, Female, Adaptive Immunity, United Kingdom epidemiology, Adult, Immunity, Innate, Herpes Zoster immunology, Herpes Zoster virology, Genome-Wide Association Study, Herpesvirus 3, Human immunology, HLA Antigens genetics, HLA Antigens immunology
Abstract

The varicella-zoster virus (VZV) infects >95% of the population. VZV reactivation causes herpes zoster (HZ), known as shingles, primarily affecting the elderly and individuals who are immunocompromised. However, HZ can occur in otherwise healthy individuals. We analyzed the immune signature and risk profile in patients with HZ using a genome-wide association study across different UK Biobank HZ cohorts. Additionally, we conducted one of the largest HZ human leukocyte antigen association studies to date, coupled with transcriptomic analysis of pathways underlying HZ susceptibility. Our findings highlight the significance of the major histocompatibility complex locus for HZ development, identifying 5 protective and 4 risk human leukocyte antigen alleles. This demonstrates that HZ susceptibility is largely governed by variations in the major histocompatibility complex. Furthermore, functional analyses revealed the upregulation of type I interferon and adaptive immune responses. These findings provide fresh molecular insights into the pathophysiology and activation of innate and adaptive immune responses triggered by symptomatic VZV reactivation., Competing Interests: Potential conflicts of interest. J.-L. C. is an inventor on patent application PCT/US2021/042741 (filed 22 July 2021; submitted by The Rockefeller University), which covers diagnosis of susceptibility to, and treatment of, viral disease and viral vaccines, including COVID-19 and vaccine-associated diseases. B. O., K. L., and P. M. are employees and/or stockholders of Immunewatch, which is a spin-off company focusing on the development of artificial intelligence–based models that give insights into the T-cell response. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed., (© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Published
2024
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45. Epidemiology and genetic diversity of linezolid-resistant Enterococcus clinical isolates in Belgium from 2013 to 2021.

Author

Mortelé O, van Kleef-van Koeveringe S, Vandamme S, Jansens H, Goossens H, and Matheeussen V

Subjects
Humans, Belgium epidemiology, Aged, Female, Male, Middle Aged, Adult, Aged, 80 and over, Young Adult, Adolescent, Child, Child, Preschool, RNA, Ribosomal, 23S genetics, Infant, Linezolid pharmacology, Gram-Positive Bacterial Infections microbiology, Gram-Positive Bacterial Infections epidemiology, Genetic Variation, Microbial Sensitivity Tests, Enterococcus faecalis genetics, Enterococcus faecalis drug effects, Enterococcus faecalis isolation & purification, Enterococcus faecium genetics, Enterococcus faecium drug effects, Enterococcus faecium isolation & purification, Anti-Bacterial Agents pharmacology, Whole Genome Sequencing, Drug Resistance, Bacterial
Abstract

Objectives: Linezolid-resistant opportunistic human pathogens Enterococcus faecalis and Enterococcus faecium are emerging health threats as limited therapeutic options remain. The aim of this study was to investigate the epidemiology, resistance mechanisms, and genetic diversity of linezolid-resistant enterococci (LRE) isolated between 2013 and 2021 and received at the Belgian National Reference Centre (NRC) for Enterococci., Methods: Linezolid susceptibility testing was performed upon request on 2458 submitted enterococci strains. Whole-genome sequencing was performed on all LRE strains., Results: Seventy-eight LRE human isolates, of which 63 (81%) E. faecalis and 15 (19%) E. faecium strains, were submitted to the Belgian NRC for Enterococci. Of the linezolid-resistant E. faecalis strains, 97% harboured the optrA gene (56% wild-type pE349) and 3% the poxtA gene. Of the linezolid-resistant E. faecium strains, 54% harboured the G2576T point mutation in the V domain of the 23S rRNA genes, 23% the poxtA, and 23% the optrA gene. Furthermore, two E. faecium strains were identified with a combination of two resistance mechanisms ([i] optrA and poxtA, and [ii] cfr(B) and G2576T point mutation, respectively). Vancomycin resistance was observed in 15% (n = 12) of the LRE. ST480 (n = 42/63 typed strains, 67%) was the most frequently detected sequence type (ST) in linezolid-resistant E. faecalis strains, while ST203 (n = 5/15 typed strains, 33%) was the most frequently detected ST in linezolid-resistant E. faecium strains., Conclusions: E. faecalis isolates harbouring optrA were the predominant LRE in Belgium, with ST480 as the most prominent multilocus sequence typing. Linezolid resistance in E. faecium could be attributed to either chromosomal mutations or transferable resistance determinants., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Published
2024
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46. Modeling antigen-specific T cell dynamics following Hepatitis B Vaccination indicates differences between conventional and regulatory T cell dynamics.

Author

Besbassi H, Elias G, Meysman P, Jansens H, Laukens K, Damme PV, Hens N, Beutels P, and Ogunjimi B

Subjects
Humans, Hepatitis B immunology, Hepatitis B prevention & control, Memory T Cells immunology, Male, Adult, Female, Herpesvirus 1, Human immunology, Herpesvirus 4, Human immunology, Young Adult, Immunologic Memory immunology, T-Lymphocytes, Regulatory immunology, Hepatitis B Vaccines immunology, Hepatitis B Vaccines administration & dosage, Vaccination
Abstract

Our study aims to investigate the dynamics of conventional memory T cells (Tconv) and regulatory memory T cells (Treg) following activation, and to explore potential differences between these two cell types. To achieve this, we developed advanced statistical mixed models based on mathematical models of ordinary differential equations (ODE), which allowed us to transform post-vaccination immunological processes into mathematical formulas. These models were applied to in-house data from a de novo Hepatitis B vaccination trial. By accounting for inter- and intra-individual variability, our models provided good fits for both antigen-specific Tconv and Treg cells, overcoming the challenge of studying these complex processes. Our modeling approach provided a deeper understanding of the immunological processes underlying T cell development after vaccination. Specifically, our analysis revealed several important findings regarding the dynamics of Tconv and Treg cells, as well as their relationship to seropositivity for Herpes Simplex Virus Type 1 (HSV-1) and Epstein-Barr Virus (EBV), and the dynamics of antibody response to vaccination. Firstly, our modeling indicated that Tconv dynamics suggest the existence of two T cell types, in contrast to Treg dynamics where only one T cell type is predicted. Secondly, we found that individuals who converted to a positive antibody response to the vaccine earlier had lower decay rates for both Tregs and Tconv cells, which may have important implications for the development of more effective vaccination strategies. Additionally, our modeling showed that HSV-1 seropositivity negatively influenced Tconv cell expansion after the second vaccination, while EBV seropositivity was associated with higher Treg expansion rates after vaccination. Overall, this study provides a critical foundation for understanding the dynamic processes underlying T cell development after vaccination., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Benson Ogunjimi reports financial support was provided by European Research Council. Benson Ogunjimi reports financial support was provided by Research Foundation Flanders. Philippe Beutels reports financial support was provided by University of Antwerp. Pierre Van Damme reports financial support was provided by University of Antwerp. CONFLICT OF INTEREST STATEMENT: BO declares that the University Hospital Antwerpen and the University of Antwerp have received investigator-initiated grants from Abbvie, Pfizer and Roche. BO is a shareholder and member of the board of ImmuneWatch BV. NH declares that the Universities of Antwerp and Hasselt have received funding for advisory boards and research projects of MSD, GSK, JnJ, Pfizer and the European Commission’s IMI programme outside the proposed work. NH has not received any personal remuneration. PB declares the University of Antwerp received compensation for unrelated consultancy for Pfizer in 2019, research grants from MSD and Pfizer, and the European Commission’s IMI programme. PB has not received any personal remuneration. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. KL is a shareholder and member of the board of ImmuneWatch BV. PM is a shareholder, employee and member of the board of ImmuneWatch BV. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Published
2024
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47. Preanalytical variables influencing the interpretation and reporting of biological tests on blood samples of living and deceased donors for human body materials.

Author

Padalko E, Colenbie L, Delforge A, Ectors N, Guns J, Imbert R, Jansens H, Pirnay JP, Rodenbach MP, Van Riet I, Vansteenbrugge A, Verbeken G, Baltes M, and Beele H

Subjects
Humans, Living Donors, Human Body, Tissue and Organ Procurement, Pre-Analytical Phase, Specimen Handling methods, Blood Specimen Collection methods, Tissue Donors
Abstract

With the present paper, the Working Group on Cells, Tissues and Organs and other experts of the Superior Health Council of Belgium aimed to provide stakeholders in material of human origin with advice on critical aspects of serological and nucleic acid test (NAT) testing, to improve virological safety of cell- and tissue and organ donation. The current paper focusses on a number of preanalytical variables which can be critical for any medical biology examination: (1) sampling related variables (type of samples, collection of the samples, volume of the sample, choice of specific tubes, identification of tubes), (2) variables related to transport, storage and processing of blood samples (transport, centrifugation and haemolysis, storage before and after centrifugation, use of serum versus plasma), (3) variables related to dilution (haemodilution, pooling of samples), and (4) test dependent variables (available tests and validation). Depending on the type of donor (deceased donor (heart-beating or non-heart beating) versus living donor (allogeneic, related, autologous), and the type of donated human material (cells, tissue or organs) additional factors can play a role: pre- and post-mortem sampling, conditions of sampling (e.g. morgue), haemodilution, possibility of retesting., (© 2023. The Author(s).)

Published
2024
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48. Lack of functional TCR-epitope interaction is associated with herpes zoster through reduced downstream T cell activation.

Author

Boeren M, de Vrij N, Ha MK, Valkiers S, Souquette A, Gielis S, Kuznetsova M, Schippers J, Bartholomeus E, Van den Bergh J, Michels N, Aerts O, Leysen J, Bervoets A, Lambert J, Leuridan E, Wens J, Peeters K, Emonds MP, Elias G, Vandamme N, Jansens H, Adriaensen W, Suls A, Vanhee S, Hens N, Smits E, Van Damme P, Thomas PG, Beutels P, Ponsaerts P, Van Tendeloo V, Delputte P, Laukens K, Meysman P, and Ogunjimi B

Subjects
Humans, Female, Middle Aged, Male, CD4-Positive T-Lymphocytes immunology, Aged, Adult, Epitopes, T-Lymphocyte immunology, Herpes Zoster immunology, Herpes Zoster virology, Receptors, Antigen, T-Cell metabolism, Receptors, Antigen, T-Cell immunology, Lymphocyte Activation immunology, Herpesvirus 3, Human immunology
Abstract

The role of T cell receptor (TCR) diversity in infectious disease susceptibility is not well understood. We use a systems immunology approach on three cohorts of herpes zoster (HZ) patients and controls to investigate whether TCR diversity against varicella-zoster virus (VZV) influences the risk of HZ. We show that CD4 + T cell TCR diversity against VZV glycoprotein E (gE) and immediate early 63 protein (IE63) after 1-week culture is more restricted in HZ patients. Single-cell RNA and TCR sequencing of VZV-specific T cells shows that T cell activation pathways are significantly decreased after stimulation with VZV peptides in convalescent HZ patients. TCR clustering indicates that TCRs from HZ patients co-cluster more often together than TCRs from controls. Collectively, our results suggest that not only lower VZV-specific TCR diversity but also reduced functional TCR affinity for VZV-specific proteins in HZ patients leads to lower T cell activation and consequently affects the susceptibility for viral reactivation., Competing Interests: Declaration of interests K.L., P.M., and B.O. are co-founders, board directors, and shareholders of ImmuneWatch. None of the work presented here was influenced in any way by this. ImmuneWatch had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Published
2024
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49. Epidemiology and molecular typing of multidrug-resistant bacteria in tertiary hospitals and nursing homes in Flanders, Belgium.

Author

van Kleef-van Koeveringe S, Matheeussen V, Schuermans A, De Koster S, Perales Selva N, Jansens H, De Coninck D, De Bruyne K, Mensaert K, Kluytmans-van den Bergh M, Kluytmans J, Goossens H, Dhaeze W, and Leroux-Roels I

Subjects
Humans, Belgium epidemiology, Tertiary Care Centers, Cross-Sectional Studies, Drug Resistance, Multiple, Bacterial, Bacteria, Molecular Typing, Nursing Homes, Cross Infection epidemiology, Cross Infection microbiology
Abstract

This study aimed to map MDRO carriage and potential transmission within and between three Flemish tertiary care hospitals and their neighbouring nursing homes. A cross-sectional MDRO prevalence survey was organized between October 2017 and February 2019. Perianal swabs were cultured for detection of MDRO. Determination of clonal relatedness based on wgMLST allelic profiles was performed. The prevalence of MDRO in Belgian hospitals and NHs is on the rise, compared to previous studies, and transmission in and between institutions is observed. These results re-emphasize the need for a healthcare network-wide infection prevention strategy in which WGS of MDRO strains can be supportive., (© 2023. The Author(s).)

Published
2024
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50. Genital Infection Caused by Salmonella enterica Serovar Hvittingfoss: A Case Report.

Author

De Hert E, Baïli S, Vanden Driessche M, Jansens H, Vandamme S, Jacquemyn Y, Vodolazkaia A, Mukovnikova M, Mattheus W, and Matheeussen V

Abstract

Background: Nontyphoidal Salmonella serovars predominantly cause gastrointestinal infections. However, other clinical presentations, including urogenital infections, have been reported, although they are rather rare., Case Presentation: This case is about a 33-year-old woman diagnosed with Salmonella enterica serovar Hvittingfoss ( S. Hvittingfoss) bacteremia and endometritis six days post uterine aspiration in the context of a missed abortion. She had traveled to Indonesia two weeks prior to the positive blood and cervical culture. She never developed gastrointestinal symptoms but was found to carry S. Hvittingfoss in her stool sample. The patient was successfully treated with a seven-day course of iv ciprofloxacin., Conclusions: S. Hvittingfoss is a rare serovar that has caused a few outbreaks of foodborne infections in Asia, the United States, and Australia. To the best of our knowledge, this is the first reported case of Salmonella urogenital infection caused by this serovar. Salmonella as a cause of urogenital infections is rare but not uncommon. Therefore, it should be considered in identifying members of the Enterobacterales among urogenital flora in cases of severe urogenital infections, especially when other cultures remain negative.

Published
2023
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