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4. Quality of MALDI-TOF mass spectra in routine diagnostics: results from an international external quality assessment including 36 laboratories from 12 countries using 47 challenging bacterial strains

Author

Cuénod, Aline, Aerni, Martina, Bagutti, Claudia, Bayraktar, Banu, Boz, Efe Serkan, Carneiro, Cynthia Beisert, Casanova, Carlo, Coste, Alix T., Damborg, Peter, van Dam, Dirk W., Demirci, Mehmet, Drevinek, Pavel, Dubuis, Olivier, Fernandez, José, Greub, Gilbert, Hrabak, Jaroslav, Hürkal Yiğitler, Gülen, Hurych, Jakub, Jensen, Thøger Gorm, Jost, Géraldine, Kampinga, Greetje A., Kittl, Sonja, Lammens, Christine, Lang, Claudia, Lienhard, Reto, Logan, Julie, Maffioli, Carola, Mareković, Ivana, Marschal, Matthias, Moran-Gilad, Jacob, Nolte, Oliver, Oberle, Michael, Pedersen, Michael, Pflüger, Valentin, Pranghofer, Sigrid, Reichl, Julia, Rentenaar, Rob J., Riat, Arnaud, Rodríguez-Sánchez, Belén, Schilt, Camille, Schlotterbeck, Ann-Kathrin, Schrenzel, Jacques, Troib, Shani, Willems, Elise, Wootton, Mandy, Ziegler, Dominik, and Egli, Adrian

Published
2023
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8. Whole-genome sequence-informed MALDI-TOF MS diagnostics reveal importance of Klebsiella oxytoca group in invasive infections: a retrospective clinical study

Author

Cuénod, Aline, Wüthrich, Daniel, Seth-Smith, Helena M. B., Ott, Chantal, Gehringer, Christian, Foucault, Frédéric, Mouchet, Roxanne, Kassim, Ali, Revathi, Gunturu, Vogt, Deborah R., von Felten, Stefanie, Bassetti, Stefano, Tschudin-Sutter, Sarah, Hettich, Timm, Schlotterbeck, Götz, Homberger, Christina, Casanova, Carlo, Moran-Gilad, Jacob, Sagi, Orli, Rodríguez-Sánchez, Belén, Müller, Franco, Aerni, Martina, Gaia, Valeria, van Dessel, Helke, Kampinga, Greetje A., Müller, Claudia, Daubenberger, Claudia, Pflüger, Valentin, and Egli, Adrian

Published
2021
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9. Paradoxal Trends in Azole-Resistant Aspergillus fumigatus in a National Multicenter Surveillance Program, the Netherlands, 2013-2018

Author

Lestrade, Pieter P.A., BuiI, Jochem B., van der Beek, Martha T., Kujper, Ed.J., van Djk, Karin, Kampinga, Greetje A., Rijnders, Bart J.A., Vonk, Alieke G., de Greeff, Sabine C., Schoffelen, Annelot F., van Dissel, Jaap, Meis, Jacques F., Melchers, Willem J.G., and Verwej, Paul E.

Subjects
Ibrutinib, Posaconazole, Health
Abstract

Aspergillus fumigatus is a saprobic mold that thrives on decaying plant material. The fungus is thermotolerant and exhibits optimum growth at 37[degrees]C. A. fumigatus has evolved into an major cause [...]

Published
2020
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10. Contact precautions in single-bed or multiple-bed rooms for patients with extended-spectrum β-lactamase-producing Enterobacteriaceae in Dutch hospitals: a cluster-randomised, crossover, non-inferiority study

Author

Bonten, Marc, Bootsma, Martin, de Brauwer, Els, Bruijning-Verhagen, Patricia, Buiting, Anton, Diederen, Bram, van Elzakker, Erika, Friedrich, Alexander, Hopman, Joost, Kampinga, Greetje, van Keulen, Peter, Kluytmans, Jan, Kluytmans-van den Bergh, Marjolein, al Naiemi, Nashwan, Oudhuis, Guy, Raangs, Erwin, Rosema, Sigrid, Rossen, John, Ruijs, Gijs, Savelkoul, Paul, Troelstra, Annet, Vandenbroucke-Grauls, Christina, Verduin, Kees, Verhulst, Carlo, Vos, Margreet, Voss, Andreas, Willems, Rob, Willemsen, Ina, Kluytmans-van den Bergh, Marjolein F Q, Bruijning-Verhagen, Patricia C J, Vandenbroucke-Grauls, Christina M J E, de Brauwer, Els I G B, Buiting, Anton G M, Diederen, Bram M, van Elzakker, Erika P M, Friedrich, Alex W, Rossen, John W A, Ruijs, Gijs J H M, Savelkoul, Paul H M, Vos, Margreet C, Bonten, Marc J M, and Kluytmans, Jan A J W

Published
2019
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14. Selective reporting of antibiotic susceptibility test results in European countries: an ESCMID cross-sectional survey

Author

Presterl, Elisabeth, Gurbanov, Akif, Piérard, Denis, Uzunovic, Selma, Vatcheva-Dobrevska, Rossitza, Tambic, Arjana, Zemlickova, Helena, Skov, Robert L., Naaber, Paul, Hakanen, Antti, Jarlier, Vincent, Gatermann, Sören, Tsakris, Athanassios, Ludwig, Endre, Helgason, Kristján Orri, Schaffer, Kirsten, Carmeli, Yehuda, Sarti, Mario, Raka, Lul, Balode, Arta, Bosevska, Golubinka, Kampinga, Greetje A., Lindemann, Paul Christoffer, Żabicka, Dorota, Alves, Valquíria, Săndulescu, Oana, Sukhorukova, Marina, Matic, Snezana, Niks, Milan, Štrumbelj, Iztok, Martínez-Martínez, Luis, Wistedt, Annika, Sax, Hugo, Gür, Deniz, Bamford, Kathleen B., Liashko, Viktor, Pulcini, Céline, Tebano, Gianpiero, Mutters, Nico T., Tacconelli, Evelina, Cambau, Emmanuelle, and Kahlmeter, Gunnar

Published
2017
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15. Clinical Impact of Polymerase Chain Reaction–based Aspergillus and Azole Resistance Detection in Invasive Aspergillosis: A Prospective Multicenter Study

Author

Huygens, Sammy, primary, Dunbar, Albert, additional, Buil, Jochem B, additional, Klaassen, Corné H W, additional, Verweij, Paul E, additional, van Dijk, Karin, additional, de Jonge, Nick, additional, Janssen, Jeroen J W M, additional, van der Velden, Walter J F M, additional, Biemond, Bart J, additional, Bart, Aldert, additional, Bruns, Anke H W, additional, Haas, Pieter-Jan A, additional, Demandt, Astrid M P, additional, Oudhuis, Guy, additional, von dem Borne, Peter, additional, van der Beek, Martha T, additional, Klein, Saskia K, additional, Godschalk, Peggy, additional, Span, Lambert F R, additional, Postma, Douwe F, additional, Kampinga, Greetje A, additional, Maertens, Johan, additional, Lagrou, Katrien, additional, Mercier, Toine, additional, Moors, Ine, additional, Boelens, Jerina, additional, Selleslag, Dominik, additional, Reynders, Marijke, additional, Zandijk, Willemien, additional, Doorduijn, Jeanette K, additional, Cornelissen, Jan J, additional, Schauwvlieghe, Alexander F A D, additional, and Rijnders, Bart J A, additional

Published
2023
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16. Clinical Impact of Polymerase Chain Reaction-Based Aspergillus and Azole Resistance Detection in Invasive Aspergillosis:A Prospective Multicenter Study

Author

Huygens, S, Dunbar, Albert, Buil, Jochem B, Klaassen, Corné H W, Verweij, Paul E, van Dijk, Karin, de Jonge, Nick, Janssen, Jeroen J W M, van der Velden, Walter J F M, Biemond, Bart J, Bart, Aldert, Bruns, Anke H W, Haas, Pieter-Jan A, Demandt, Astrid M P, Oudhuis, Guy, von dem Borne, Peter, van der Beek, Martha T, Klein, Saskia K, Godschalk, Peggy, Span, Lambert F R, Postma, Douwe F, Kampinga, Greetje A, Maertens, Johan, Lagrou, Katrien, Mercier, Toine, Moors, Ine, Boelens, Jerina, Selleslag, Dominik, Reynders, Marijke, Zandijk, Willemien, Doorduijn, Jeanette K, Cornelissen, Jan J, Schauwvlieghe, Alexander F A D, Rijnders, Bart J A, Huygens, S, Dunbar, Albert, Buil, Jochem B, Klaassen, Corné H W, Verweij, Paul E, van Dijk, Karin, de Jonge, Nick, Janssen, Jeroen J W M, van der Velden, Walter J F M, Biemond, Bart J, Bart, Aldert, Bruns, Anke H W, Haas, Pieter-Jan A, Demandt, Astrid M P, Oudhuis, Guy, von dem Borne, Peter, van der Beek, Martha T, Klein, Saskia K, Godschalk, Peggy, Span, Lambert F R, Postma, Douwe F, Kampinga, Greetje A, Maertens, Johan, Lagrou, Katrien, Mercier, Toine, Moors, Ine, Boelens, Jerina, Selleslag, Dominik, Reynders, Marijke, Zandijk, Willemien, Doorduijn, Jeanette K, Cornelissen, Jan J, Schauwvlieghe, Alexander F A D, and Rijnders, Bart J A

Abstract

BACKGROUND: Invasive aspergillosis (IA) by a triazole-resistant Aspergillus fumigatus is associated with high mortality. Real-time resistance detection will result in earlier initiation of appropriate therapy. METHODS: In a prospective study, we evaluated the clinical value of the AsperGenius polymerase chain reaction (PCR) assay in hematology patients from 12 centers. This PCR assay detects the most frequent cyp51A mutations in A. fumigatus conferring azole resistance. Patients were included when a computed tomography scan showed a pulmonary infiltrate and bronchoalveolar fluid (BALf) sampling was performed. The primary end point was antifungal treatment failure in patients with azole-resistant IA. RESULTS: Of 323 patients enrolled, complete mycological and radiological information was available for 276 (94%), and probable IA was diagnosed in 99/276 (36%). Sufficient BALf for PCR testing was available for 293/323 (91%). Aspergillus DNA was detected in 116/293 (40%) and A. fumigatus DNA in 89/293 (30%). The resistance PCR was conclusive in 58/89 (65%) and resistance detected in 8/58 (14%). Two had a mixed azole-susceptible/azole-resistant infection. In the 6 remaining patients, treatment failure was observed in 1. Galactomannan positivity was associated with mortality (P = .004) while an isolated positive Aspergillus PCR was not (P = .83). CONCLUSIONS: Real-time PCR-based resistance testing may help to limit the clinical impact of triazole resistance. In contrast, the clinical impact of an isolated positive Aspergillus PCR on BALf seems limited. The interpretation of the EORTC/MSGERC PCR criterion for BALf may need further specification (eg, minimum cycle threshold value and/or PCR positive on >1 BALf sample).

Published
2023

17. Quality of MALDI-TOF mass spectra in routine diagnostics:results from an international external quality assessment including 36 laboratories from 12 countries using 47 challenging bacterial strains

Author

Cuénod, Aline, Aerni, Martina, Bagutti, Claudia, Bayraktar, Banu, Boz, Efe Serkan, Carneiro, Cynthia Beisert, Casanova, Carlo, Coste, Alix T., Damborg, Peter, van Dam, Dirk W., Demirci, Mehmet, Drevinek, Pavel, Dubuis, Olivier, Fernandez, José, Greub, Gilbert, Hrabak, Jaroslav, Hürkal Yiğitler, Gülen, Hurych, Jakub, Jensen, Thøger Gorm, Jost, Géraldine, Kampinga, Greetje A., Kittl, Sonja, Lammens, Christine, Lang, Claudia, Lienhard, Reto, Logan, Julie, Maffioli, Carola, Mareković, Ivana, Marschal, Matthias, Moran-Gilad, Jacob, Nolte, Oliver, Oberle, Michael, Pedersen, Michael, Pflüger, Valentin, Pranghofer, Sigrid, Reichl, Julia, Rentenaar, Rob J., Riat, Arnaud, Rodríguez-Sánchez, Belén, Schilt, Camille, Schlotterbeck, Ann Kathrin, Schrenzel, Jacques, Troib, Shani, Willems, Elise, Wootton, Mandy, Ziegler, Dominik, Egli, Adrian, Cuénod, Aline, Aerni, Martina, Bagutti, Claudia, Bayraktar, Banu, Boz, Efe Serkan, Carneiro, Cynthia Beisert, Casanova, Carlo, Coste, Alix T., Damborg, Peter, van Dam, Dirk W., Demirci, Mehmet, Drevinek, Pavel, Dubuis, Olivier, Fernandez, José, Greub, Gilbert, Hrabak, Jaroslav, Hürkal Yiğitler, Gülen, Hurych, Jakub, Jensen, Thøger Gorm, Jost, Géraldine, Kampinga, Greetje A., Kittl, Sonja, Lammens, Christine, Lang, Claudia, Lienhard, Reto, Logan, Julie, Maffioli, Carola, Mareković, Ivana, Marschal, Matthias, Moran-Gilad, Jacob, Nolte, Oliver, Oberle, Michael, Pedersen, Michael, Pflüger, Valentin, Pranghofer, Sigrid, Reichl, Julia, Rentenaar, Rob J., Riat, Arnaud, Rodríguez-Sánchez, Belén, Schilt, Camille, Schlotterbeck, Ann Kathrin, Schrenzel, Jacques, Troib, Shani, Willems, Elise, Wootton, Mandy, Ziegler, Dominik, and Egli, Adrian

Abstract

Objectives: Matrix assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry (MS) is a widely used method for bacterial species identification. Incomplete databases and mass spectral quality (MSQ) still represent major challenges. Important proxies for MSQ are the number of detected marker masses, reproducibility, and measurement precision. We aimed to assess MSQs across diagnostic laboratories and the potential of simple workflow adaptations to improve it. Methods: For baseline MSQ assessment, 47 diverse bacterial strains, which are challenging to identify by MALDI-TOF MS, were routinely measured in 36 laboratories from 12 countries, and well-defined MSQ features were used. After an intervention consisting of detailed reported feedback and instructions on how to acquire MALDI-TOF mass spectra, measurements were repeated and MSQs were compared. Results: At baseline, we observed heterogeneous MSQ between the devices, considering the median number of marker masses detected (range = [2–25]), reproducibility between technical replicates (range = [55%–86%]), and measurement error (range = [147 parts per million (ppm)–588 ppm]). As a general trend, the spectral quality was improved after the intervention for devices, which yielded low MSQs in the baseline assessment as follows: for four out of five devices with a high measurement error, the measurement precision was improved (p-values <0.001, paired Wilcoxon test); for six out of ten devices, which detected a low number of marker masses, the number of detected marker masses increased (p-values <0.001, paired Wilcoxon test). Discussion: We have identified simple workflow adaptations, which, to some extent, improve MSQ of poorly performing devices and should be considered by laboratories yielding a low MSQ. Improving MALDI-TOF MSQ in routine diagnostics is essential for increasing the resolution of bacterial identification by MALDI-TOF MS, which is dependent on the reproducible detection of

Published
2023

18. Clinical impact of PCR-based Aspergillus and azole resistance detection in invasive aspergillosis. A prospective multicenter study

Author

Huygens, S, Dunbar, Albert, Buil, Jochem B, Klaassen, Corné H W, Verweij, Paul E, van Dijk, Karin, de Jonge, Nick, Janssen, Jeroen J W M, van der Velden, Walter J F M, Biemond, Bart J, Bart, Aldert, Bruns, Anke H W, Haas, Pieter-Jan A, Demandt, Astrid M P, Oudhuis, Guy, von dem Borne, Peter, van der Beek, Martha T, Klein, Saskia K, Godschalk, Peggy, Span, Lambert F R, Postma, Douwe F, Kampinga, Greetje A, Maertens, Johan, Lagrou, Katrien, Mercier, Toine, Moors, Ine, Boelens, Jerina, Selleslag, Dominik, Reynders, Marijke, Zandijk, Willemien, Doorduijn, Jeanette K, Cornelissen, Jan J, Schauwvlieghe, Alexander F A D, Rijnders, Bart J A, Internal Medicine, Medical Microbiology & Infectious Diseases, and Hematology

Abstract

BACKGROUND: Invasive aspergillosis(IA) by a triazole resistant Aspergillus fumigatus is associated with a high mortality. Real-time resistance detection will result in earlier initiation of appropriate therapy. METHODS: In a prospective study in the Netherlands and Belgium, we evaluated the clinical value of the multiplex AsperGenius®PCR in hematology patients from 12 centers. This PCR detects the most frequent cyp51A mutations in A. fumigatus conferring azole-resistance. Patients were included when a CT-scan showed a pulmonary infiltrate and bronchoalveolar lavage(BALf) sampling was performed. The primary endpoint was antifungal treatment failure in patients with azole-resistant IA. Patients with mixed azole-susceptible/resistant infections were excluded. RESULTS: Of 323 patients enrolled, complete mycological and radiological information was available in 276/323(94%) and probable IA diagnosed in 99/276(36%). Sufficient BALf for PCR testing was available in 293/323(91%). Aspergillus DNA was detected in 116/293(40%) and A.fumigatus DNA in 89/293(30%). The resistance PCR was conclusive in 58/89(65%) and resistance detected in 8/58(14%). Two had a mixed azole-susceptible/resistant infection. In the 6 remaining patients, treatment failure was observed in one. Galactomannan positivity was associated with higher mortality(p=0.004). In contrast, mortality of patients with an isolated positive Aspergillus PCR was comparable to those with a negative PCR(p=0.83). CONCLUSIONS: Real-time PCR-based resistance testing may help to limit the clinical impact of triazole resistance. In contrast, the clinical impact of an isolated positive Aspergillus PCR on BALf seems limited. The interpretation of the EORTC/MSGERC PCR criterion for BALf may need further specification (e.g. minimum Ct-value and/or PCR positive on >1 BALf sample).

Published
2023

23. Quality of MALDI-TOF mass spectra in routine diagnostics: results from and international external quality assessment including 36 labs

Author

Cuenod, Aline, Aerni, Martina, Bagutti, Claudia, Bayraktar, Banu, Beisert carneiro, Cynthia, casanova, Carlo, Coste, Alix T., Dambor, Peter, van DAm, DIck, Demirci, Mehmet, Hrabak, Jaroslav, Hurych, Jakub, Jensen, Thoger Gorm, Jost, Geraldine, Kampinga, Greetje A., Kitti, Sonja, Lammens, Christine, lang, Claudia, Lienhard, Reto, Logan, Julie, maffioli, Carola, Mareković, Ivana, Marschal, Matthias, Moran- Gilad, Jacob, Nole, Oliver, Oberle, Michael, Pedersen, Micahel, Pfluger, valentin: Pranghofer Sigrid, Reichl, Julia, Rentenaar, Rob, Riat, Arnaud, Rodriguez- Sanchez, Belen, Willems, Elise, Wootton, Mandy, Ziegler, Dominik, and Egli, Adrian

Subjects
MALDI-TOF mass spectrometry, identification, quality control
Abstract

Applying our workflow adaptations can be helpful for laboratories generating low quality mass spectra. The data acquired in this study suggest that these simple workflow adaptations are not sufficient to reach highest mass spectra quality in all cases, but other factors such as device maintenance may be helpful.

Published
2022

24. A prospective multicentre screening study on multidrug-resistant organisms in intensive care units in the Dutch–German cross-border region, 2017 to 2018: the importance of healthcare structures

Author

Glasner, Corinna, primary, Berends, Matthijs S, additional, Becker, Karsten, additional, Esser, Jutta, additional, Gieffers, Jens, additional, Jurke, Annette, additional, Kampinga, Greetje, additional, Kampmeier, Stefanie, additional, Klont, Rob, additional, Köck, Robin, additional, von Müller, Lutz, additional, al Naemi, Nashwan, additional, Ott, Alewijn, additional, Ruijs, Gijs, additional, Saris, Katja, additional, Tami, Adriana, additional, Voss, Andreas, additional, Waar, Karola, additional, van Zeijl, Jan, additional, and Friedrich, Alex W, additional

Published
2022
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25. Absence of host-specific genes in canine and human staphylococcus pseudintermedius as inferred from comparative genomics

Author

Wegener, Alice, Broens, Els M, van der Graaf-van Bloois, Linda, Zomer, Aldert L, Visser, Caroline E, van Zeijl, Jan, van der Meer, Coby, Kusters, Johannes G, Friedrich, Alex W, Kampinga, Greetje A, Sips, Gregorius J, Smeets, Leonard, van Kerckhoven, Manfred E J, Timmerman, Arjen J, Wagenaar, Jaap A, Duim, Birgitta, dI&I I&I-4, Klinische infectiologie en microb. lab., Medical Microbiology and Infection Prevention, dI&I I&I-4, Klinische infectiologie en microb. lab., Microbes in Health and Disease (MHD), and Medical Microbiology & Infectious Diseases

Subjects
Staphylococcus pseudintermedius, Epidemiology, Genome-wide association study, Antimicrobial resistance, Biochemistry, EMERGENCE, Pharmacology, Toxicology and Pharmaceutics(all), Plasmid, pseudintermedius, Pharmacology (medical), General Pharmacology, Toxicology and Pharmaceutics, Pathogen, Genetics, 0303 health sciences, biology, Bacteriologie, Bacteriology, Host Pathogen Interaction & Diagnostics, INSIGHTS, S. pseudintermedius, Infectious Diseases, INFECTIONS, INTERMEDIUS GROUP, Microbiology (medical), Bioinformatica & Diermodellen, RM1-950, Microbiology, Article, Host association, 03 medical and health sciences, Antibiotic resistance, SDG 3 - Good Health and Well-being, Bio-informatics & Animal models, Epidemiology, Bio-informatics & Animal models, Gene, 030304 developmental biology, Pharmacology, Host Pathogen Interaction & Diagnostics, Epidemiologie, Comparative genomics, 030306 microbiology, Bacteriology, biology.organism_classification, Host Pathogen Interactie & Diagnostiek, Multiple drug resistance, Toxicology and Pharmaceutics(all), Epidemiologie, Bioinformatica & Diermodellen, Bacteriologie, Host Pathogen Interactie & Diagnostiek, Therapeutics. Pharmacology
Abstract

Staphylococcus pseudintermedius is an important pathogen in dogs that occasionally causes infections in humans as an opportunistic pathogen of elderly and immunocompromised people. This study compared the genomic relatedness and antimicrobial resistance genes using genome-wide association study (GWAS) to examine host association of canine and human S. pseudintermedius isolates. Canine (n = 25) and human (n = 32) methicillin-susceptible S. pseudintermedius (MSSP) isolates showed a high level of genetic diversity with an overrepresentation of clonal complex CC241 in human isolates. This clonal complex was associated with carriage of a plasmid containing a bacteriocin with cytotoxic properties, a CRISPR-cas domain and a pRE25-like mobile element containing five antimicrobial resistance genes. Multi-drug resistance (MDR) was predicted in 13 (41%) of human isolates and 14 (56%) of canine isolates. CC241 represented 54% of predicted MDR isolates from humans and 21% of predicted MDR canine isolates. While it had previously been suggested that certain host-specific genes were present the current GWAS analysis did not identify any genes that were significantly associated with human or canine isolates. In conclusion, this is the first genomic study showing that MSSP is genetically diverse in both hosts and that multidrug resistance is important in dog and human-associated S. pseudintermedius isolates.

Published
2021

26. A high prevalence of Cutibacterium acnesinfections in scoliosis revision surgery, a diagnostic and therapeutic dilemma

Author

Gelderman, Stefan J., Faber, Christhoper, Kampinga, Greetje A., Jutte, Paul C., Ploegmakers, Joris J. W., Glaudemans, Andor W. J. M., and Wouthuyzen-Bakker, Marjan

Abstract

Purpose: To investigate if serum inflammatory markers or nuclear imaging can accurately diagnose a chronic spinal instrumentation infection (SII) prior to surgery. Methods: All patients who underwent revision of spinal instrumentation after a scoliosis correction between 2017 and 2019, were retrospectively evaluated. The diagnostic accuracy of serum C-reactive protein (CRP) and Erythrocyte Sedimentation Rate (ESR), 18F-fluorodeoxyglucose positron emission tomography combined with computed tomography (FDG–PET/CT) and Technetium-99m-methylene diphosphonate (99mTc-MDP) 3-phase bone scintigraphy (TPBS) to diagnose infection were studied. Patients with an acute infection or inadequate culture sampling were excluded. SII was diagnosed if ≥ 2 of the same microorganism(s) were isolated from intra-operative tissue cultures. Results: 30 patients were included. The indication for revision surgery was pseudoarthrosis in the majority of patients (n = 15). 22 patients (73%) were diagnosed with SII. In all infected cases, Cutibacterium acneswas isolated, including 5 cases with a polymicrobial infection. The majority of patients had low inflammatory parameters preoperatively. For CRP > 10.0 mg/L, the sensitivity was 9.1% and specificity 100%; for ESR > 30 mm/h, the sensitivity was 9.1% and specificity 100%. The diagnostic accuracy for nuclear imaging was 64% for the FDG–PET/CT and 67% for the TPBS to diagnose infection. Conclusions: The prevalence of SII in patients undergoing revision spinal surgery is high, with Cutibacterium acnesas the main pathogen. No diagnostic tests could be identified that could accurately diagnose or exclude SII prior to surgery. Future studies should aim to find more sensitive diagnostic modalities to detect low-grade inflammation.

Published
2023
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27. Additional file 1 of Whole-genome sequence-informed MALDI-TOF MS diagnostics reveal importance of Klebsiella oxytoca group in invasive infections: a retrospective clinical study

Author

Cuénod, Aline, Wüthrich, Daniel, Seth-Smith, Helena M. B., Ott, Chantal, Gehringer, Christian, Foucault, Frédéric, Mouchet, Roxanne, Kassim, Ali, Revathi, Gunturu, Vogt, Deborah R., von Felten, Stefanie, Bassetti, Stefano, Tschudin-Sutter, Sarah, Hettich, Timm, Schlotterbeck, Götz, Homberger, Christina, Casanova, Carlo, Moran-Gilad, Jacob, Sagi, Orli, Rodríguez-Sánchez, Belén, Müller, Franco, Aerni, Martina, Gaia, Valeria, van Dessel, Helke, Kampinga, Greetje A., Müller, Claudia, Daubenberger, Claudia, Pflüger, Valentin, and Egli, Adrian

Abstract

Additional file 1: Figure S1. Schematic representation of the workflow of the project. Figure S2. Gene accumulation curves for species of the K. pneumoniae group (A) and the K. oxytoca group (B). Figure S3. Genes associated with AMR detected in Klebsiella spp.Figure S4. Partial least squares discriminant analysis (PLS-DA) score plot containing primary metabolites measured of five Klebsiella spp.Figure S5. Species identity of datasets (a), (b) and (c) included in the statistical analysis.

Published
2021
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28. Increasing MALDI-TOF mass spectral quality increases the resolution of species identification

Author

Cuénod, Aline, Aerni, Martina, Bagutti, Claudia, Bayraktar, Banu, Carneiro, Cynthia, Casanova, Carlo, Coste, Alix T., Damborg, Peter, van Dam, Dick, Demirci, Mehmet, Hrabak, Jaroslav, Yiğitler, Hurych, Jakub, Kampinga, Greetje A. Logan, Julie, Mareković, Ivana, Marschal, Matthias, Moran-Gilad, Jacob, Nolte, Oliver, Pedersen, Michael, Pflüger, Valentin, Riat, Arnaud, Rodríguez-Sánchez, Belén, Willems, Elise, and Egli, Adrian

Subjects
MALDI-TOF mass spectrometry, identification, quality control
Abstract

We have shown that the laboratory procedures imapct spectral quality. based on the data acquired within this study, we have developed protocols, likely able to increase mass spectral quality. This will be assessed in follow-up measurements at all laboratories.

Published
2021

29. Additional file 9 of Whole-genome sequence-informed MALDI-TOF MS diagnostics reveal importance of Klebsiella oxytoca group in invasive infections: a retrospective clinical study

Author

Cuénod, Aline, Wüthrich, Daniel, Seth-Smith, Helena M. B., Ott, Chantal, Gehringer, Christian, Foucault, Frédéric, Mouchet, Roxanne, Kassim, Ali, Revathi, Gunturu, Vogt, Deborah R., von Felten, Stefanie, Bassetti, Stefano, Tschudin-Sutter, Sarah, Hettich, Timm, Schlotterbeck, Götz, Homberger, Christina, Casanova, Carlo, Moran-Gilad, Jacob, Sagi, Orli, Rodríguez-Sánchez, Belén, Müller, Franco, Aerni, Martina, Gaia, Valeria, van Dessel, Helke, Kampinga, Greetje A., Müller, Claudia, Daubenberger, Claudia, Pflüger, Valentin, and Egli, Adrian

Subjects
polycyclic compounds
Abstract

Additional file 9: Odds ratio estimates comparing Klebsiella groups and species for resistance to different antibiotic classes: Table S7. Penicillins with beta-lactamase Inhibitors. Table S8. 3rd-generation cephalosporins. Table S9. 4th-generation cephalosporins. Table S10. Aminoglycosides.

Published
2021
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30. Additional file 3 of Whole-genome sequence-informed MALDI-TOF MS diagnostics reveal importance of Klebsiella oxytoca group in invasive infections: a retrospective clinical study

Author

Cuénod, Aline, Wüthrich, Daniel, Seth-Smith, Helena M. B., Ott, Chantal, Gehringer, Christian, Foucault, Frédéric, Mouchet, Roxanne, Kassim, Ali, Revathi, Gunturu, Vogt, Deborah R., von Felten, Stefanie, Bassetti, Stefano, Tschudin-Sutter, Sarah, Hettich, Timm, Schlotterbeck, Götz, Homberger, Christina, Casanova, Carlo, Moran-Gilad, Jacob, Sagi, Orli, Rodríguez-Sánchez, Belén, Müller, Franco, Aerni, Martina, Gaia, Valeria, van Dessel, Helke, Kampinga, Greetje A., Müller, Claudia, Daubenberger, Claudia, Pflüger, Valentin, and Egli, Adrian

Abstract

Additional file 3. Supplementary methods for: Measurement of primary metabolites. Fatty acid analysis. Statistical analysis of clinical outcome data.

Published
2021
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31. Absence of Host-Specific Genes in Canine and Human Staphylococcus pseudintermedius as Inferred from Comparative Genomics

Author

dI&I I&I-4, Klinische infectiologie en microb. lab., Wegener, Alice, Broens, Els M, van der Graaf-van Bloois, Linda, Zomer, Aldert L, Visser, Caroline E, van Zeijl, Jan, van der Meer, Coby, Kusters, Johannes G, Friedrich, Alex W, Kampinga, Greetje A, Sips, Gregorius J, Smeets, Leonard, van Kerckhoven, Manfred E J, Timmerman, Arjen J, Wagenaar, Jaap A, Duim, Birgitta, dI&I I&I-4, Klinische infectiologie en microb. lab., Wegener, Alice, Broens, Els M, van der Graaf-van Bloois, Linda, Zomer, Aldert L, Visser, Caroline E, van Zeijl, Jan, van der Meer, Coby, Kusters, Johannes G, Friedrich, Alex W, Kampinga, Greetje A, Sips, Gregorius J, Smeets, Leonard, van Kerckhoven, Manfred E J, Timmerman, Arjen J, Wagenaar, Jaap A, and Duim, Birgitta

Published
2021

32. Whole-genome sequence-informed MALDI-TOF MS diagnostics reveal importance of Klebsiella oxytoca group in invasive infections: a retrospective clinical study

Author

Cuénod, Aline; https://orcid.org/0000-0002-8522-6134, Wüthrich, Daniel, Seth-Smith, Helena M B, Ott, Chantal, Gehringer, Christian, Foucault, Frédéric, Mouchet, Roxanne, Kassim, Ali, Revathi, Gunturu, Vogt, Deborah R; https://orcid.org/0000-0002-0668-5675, von Felten, Stefanie; https://orcid.org/0000-0002-5264-6394, Bassetti, Stefano, Tschudin-Sutter, Sarah; https://orcid.org/0000-0003-4875-5368, Hettich, Timm, Schlotterbeck, Götz, Homberger, Christina, Casanova, Carlo, Moran-Gilad, Jacob, Sagi, Orli, Rodríguez-Sánchez, Belén, Müller, Franco, Aerni, Martina, Gaia, Valeria, van Dessel, Helke, Kampinga, Greetje A, Müller, Claudia, Daubenberger, Claudia, Pflüger, Valentin, Egli, Adrian, Cuénod, Aline; https://orcid.org/0000-0002-8522-6134, Wüthrich, Daniel, Seth-Smith, Helena M B, Ott, Chantal, Gehringer, Christian, Foucault, Frédéric, Mouchet, Roxanne, Kassim, Ali, Revathi, Gunturu, Vogt, Deborah R; https://orcid.org/0000-0002-0668-5675, von Felten, Stefanie; https://orcid.org/0000-0002-5264-6394, Bassetti, Stefano, Tschudin-Sutter, Sarah; https://orcid.org/0000-0003-4875-5368, Hettich, Timm, Schlotterbeck, Götz, Homberger, Christina, Casanova, Carlo, Moran-Gilad, Jacob, Sagi, Orli, Rodríguez-Sánchez, Belén, Müller, Franco, Aerni, Martina, Gaia, Valeria, van Dessel, Helke, Kampinga, Greetje A, Müller, Claudia, Daubenberger, Claudia, Pflüger, Valentin, and Egli, Adrian

Abstract

BACKGROUND Klebsiella spp. are opportunistic pathogens which can cause severe infections, are often multi-drug resistant and are a common cause of hospital-acquired infections. Multiple new Klebsiella species have recently been described, yet their clinical impact and antibiotic resistance profiles are largely unknown. We aimed to explore Klebsiella group- and species-specific clinical impact, antimicrobial resistance (AMR) and virulence. METHODS We analysed whole-genome sequence data of a diverse selection of Klebsiella spp. isolates and identified resistance and virulence factors. Using the genomes of 3594 Klebsiella isolates, we predicted the masses of 56 ribosomal subunit proteins and identified species-specific marker masses. We then re-analysed over 22,000 Matrix-Assisted Laser Desorption Ionization - Time Of Flight (MALDI-TOF) mass spectra routinely acquired at eight healthcare institutions in four countries looking for these species-specific markers. Analyses of clinical and microbiological endpoints from a subset of 957 patients with infections from Klebsiella species were performed using generalized linear mixed-effects models. RESULTS Our comparative genomic analysis shows group- and species-specific trends in accessory genome composition. With the identified species-specific marker masses, eight Klebsiella species can be distinguished using MALDI-TOF MS. We identified K. pneumoniae (71.2%; n = 12,523), K. quasipneumoniae (3.3%; n = 575), K. variicola (9.8%; n = 1717), "K. quasivariicola" (0.3%; n = 52), K. oxytoca (8.2%; n = 1445), K. michiganensis (4.8%; n = 836), K. grimontii (2.4%; n = 425) and K. huaxensis (0.1%; n = 12). Isolates belonging to the K. oxytoca group, which includes the species K. oxytoca, K. michiganensis and K. grimontii, were less often resistant to 4th-generation cephalosporins than isolates of the K. pneumoniae group, which includes the species K. pneumoniae, K. quasipneumoniae, K. variicola and "K. quasivariicola" (odds ratio = 0.

Published
2021

33. Clinical implications of azole resistance in Aspergillus fumigatus, the Netherlands, 2007-2009

Author

van der Linden, Jan W.M., Snelders, Eveline, Kampinga, Greetje A., Rijnders, Bart J.A., Mattsson, Eva, Debets-Ossenkopp, Yvette J., Kuijper, Ed.J., Van Tiel, Frank H., Melchers, Willem J.G., and Verweij, Paul E.

Subjects
Gene mutations -- Health aspects, Medical research -- Health aspects, Isolation (Hospital care) -- Health aspects, Strategic planning (Business) -- Health aspects, Cystic fibrosis -- Risk factors -- Health aspects, Genes -- Health aspects, Diseases -- Risk factors -- Health aspects -- Netherlands, Hematopoietic stem cells -- Health aspects -- Transplantation, Heterocyclic compounds -- Health aspects, Cardiac patients -- Health aspects, Transplantation of organs, tissues, etc. -- Health aspects, Medicine, Experimental -- Health aspects, Leukemia -- Risk factors -- Health aspects, Drug resistance -- Risk factors -- Health aspects, Amphotericin B -- Health aspects, Antiparasitic agents -- Health aspects, Fungicides -- Health aspects, Public health -- Health aspects, Itraconazole -- Health aspects, Medical screening -- Health aspects, Health
Abstract

Azoles are the primary class of antifungal agents used for evidence-based treatment and prevention of Aspergillus spp. diseases (1). Azoles are the only class of mold-active agents that can be [...]

Published
2011
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34. Contact precautions in single-bed or multiple-bed rooms for patients with extended-spectrum β-lactamase-producing Enterobacteriaceae in Dutch hospitals : a cluster-randomised, crossover, non-inferiority study

Author

Kluytmans-van den Bergh, Marjolein, Bruijning-Verhagen, Patricia C.J., Vandenbroucke-Grauls, Christina, de Brauwer, Els I.G.B., Buiting, Anton G.M., Diederen, Bram M., van Elzakker, Erika P.M., Friedrich, Alex W., Hopman, Joost, al Naiemi, Nashwan, Rossen, John, Ruijs, Gijs J.H.M., Savelkoul, Paul H.M., Verhulst, Carlo, Vos, Margreet C., Voss, Andreas, Bonten, Marc, Kluytmans, Jan, Bootsma, Martin, de Brauwer, Els, Bruijning-Verhagen, Patricia, Buiting, Anton, Diederen, Bram, van Elzakker, Erika, Friedrich, Alexander, Kampinga, Greetje, van Keulen, Peter, Oudhuis, Guy, Raangs, Erwin, Rosema, Sigrid, Ruijs, Gijs, Troelstra, Annet, Verduin, Kees, Vos, Margreet, Willems, Rob, Willemsen, Ina, Kluytmans-van den Bergh, Marjolein, Bruijning-Verhagen, Patricia C.J., Vandenbroucke-Grauls, Christina, de Brauwer, Els I.G.B., Buiting, Anton G.M., Diederen, Bram M., van Elzakker, Erika P.M., Friedrich, Alex W., Hopman, Joost, al Naiemi, Nashwan, Rossen, John, Ruijs, Gijs J.H.M., Savelkoul, Paul H.M., Verhulst, Carlo, Vos, Margreet C., Voss, Andreas, Bonten, Marc, Kluytmans, Jan, Bootsma, Martin, de Brauwer, Els, Bruijning-Verhagen, Patricia, Buiting, Anton, Diederen, Bram, van Elzakker, Erika, Friedrich, Alexander, Kampinga, Greetje, van Keulen, Peter, Oudhuis, Guy, Raangs, Erwin, Rosema, Sigrid, Ruijs, Gijs, Troelstra, Annet, Verduin, Kees, Vos, Margreet, Willems, Rob, and Willemsen, Ina

Published
2019

36. Contact precautions in single-bed or multiple-bed rooms for patients with extended-spectrum β-lactamase-producing Enterobacteriaceae in Dutch hospitals: a cluster-randomised, crossover, non-inferiority study

Author

Kluytmans-van den Bergh, Marjolein F Q, primary, Bruijning-Verhagen, Patricia C J, additional, Vandenbroucke-Grauls, Christina M J E, additional, de Brauwer, Els I G B, additional, Buiting, Anton G M, additional, Diederen, Bram M, additional, van Elzakker, Erika P M, additional, Friedrich, Alex W, additional, Hopman, Joost, additional, al Naiemi, Nashwan, additional, Rossen, John W A, additional, Ruijs, Gijs J H M, additional, Savelkoul, Paul H M, additional, Verhulst, Carlo, additional, Vos, Margreet C, additional, Voss, Andreas, additional, Bonten, Marc J M, additional, Kluytmans, Jan A J W, additional, Bonten, Marc, additional, Bootsma, Martin, additional, de Brauwer, Els, additional, Bruijning-Verhagen, Patricia, additional, Buiting, Anton, additional, Diederen, Bram, additional, van Elzakker, Erika, additional, Friedrich, Alexander, additional, Kampinga, Greetje, additional, van Keulen, Peter, additional, Kluytmans, Jan, additional, Kluytmans-van den Bergh, Marjolein, additional, Oudhuis, Guy, additional, Raangs, Erwin, additional, Rosema, Sigrid, additional, Rossen, John, additional, Ruijs, Gijs, additional, Savelkoul, Paul, additional, Troelstra, Annet, additional, Vandenbroucke-Grauls, Christina, additional, Verduin, Kees, additional, Vos, Margreet, additional, Willems, Rob, additional, and Willemsen, Ina, additional

Published
2019
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38. 18F-FDG-PET uptake in non-infected total hip prostheses

Author

Gelderman, Stefan J, primary, Jutte, Paul C, additional, Boellaard, Ronald, additional, Ploegmakers, Joris J W, additional, Vállez García, David, additional, Kampinga, Greetje A, additional, Glaudemans, Andor W J M, additional, and Wouthuyzen-Bakker, Marjan, additional

Published
2018
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39. The diagnosis and treatment of invasive aspergillosis in Dutch haematology units facing a rapidly increasing prevalence of azole‐resistance. A nationwide survey and rationale for the DB‐MSG 002 study protocol

Author

Schauwvlieghe, Alexander F. A. D., primary, de Jonge, Nick, additional, van Dijk, Karin, additional, Verweij, Paul E., additional, Brüggemann, Roger J., additional, Biemond, Bart J., additional, Bart, Aldert, additional, von dem Borne, Peter A., additional, Verbon, Annelies, additional, van der Beek, Martha T., additional, Demandt, Astrid M. P., additional, Oudhuis, Guy J., additional, Cornelissen, Jan J., additional, van der Velden, Walter J. F. M., additional, Span, Lambert F. R., additional, Kampinga, Greetje A., additional, Bruns, Anke H., additional, Vonk, Alieke G., additional, Haas, Pieter–Jan A., additional, Doorduijn, Jeanette K., additional, and Rijnders, Bart J. A., additional

Published
2018
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40. Susceptibility of ESBL Escherichia coli and Klebsiella pneumoniae to fosfomycin in the Netherlands and comparison of several testing methods including Etest, MIC test strip, Vitek2, Phoenix and disc diffusion

Author

van den Bijllaardt, Wouter, primary, Schijffelen, Maarten J, additional, Bosboom, Ron W, additional, Cohen Stuart, James, additional, Diederen, Bram, additional, Kampinga, Greetje, additional, Le, Thuy-Nga, additional, Overdevest, Ilse, additional, Stals, Frans, additional, Voorn, Paul, additional, Waar, Karola, additional, Mouton, Johan W, additional, and Muller, Anouk E, additional

Published
2018
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41. Ribotype 078 Clostridium difficile infection incidence in Dutch hospitals is not associated with provincial pig farming: Results from a national sentinel surveillance, 2009-2015

Author

van Dorp, Sofie M., primary, de Greeff, Sabine C., additional, Harmanus, Céline, additional, Sanders, Ingrid M. J. G., additional, Dekkers, Olaf M., additional, Knetsch, Cornelis W., additional, Kampinga, Greetje A., additional, Notermans, Daan W., additional, and Kuijper, Ed J., additional

Published
2017
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42. Influenza-associated Aspergillosis in Critically III Patients

Author

van de Veerdonk, Frank L., van de Veerdonk, Frank L., Kolwijck, Eva, Lestrade, Pieter P. A., Hodiamont, Caspar J., Rijnders, Bart J. A., van Paassen, Judith, Haas, Pieter-Jan, dos Santos, Claudy Oliveira, Kampinga, Greetje A., Bergmans, Dennis C. J. J., van Dijk, Karin, de Haan, Anton F. J., van Dissel, Jaap, van der Hoeven, Hans G., Verweij, Paul E., Dutch-Belgian Mycoses Study Grp, van de Veerdonk, Frank L., van de Veerdonk, Frank L., Kolwijck, Eva, Lestrade, Pieter P. A., Hodiamont, Caspar J., Rijnders, Bart J. A., van Paassen, Judith, Haas, Pieter-Jan, dos Santos, Claudy Oliveira, Kampinga, Greetje A., Bergmans, Dennis C. J. J., van Dijk, Karin, de Haan, Anton F. J., van Dissel, Jaap, van der Hoeven, Hans G., Verweij, Paul E., and Dutch-Belgian Mycoses Study Grp

Published
2017

43. A novel environmental azole resistance mutation in Aspergillus fumigatus and a possible role of sexual reproduction in its emergence

Author

Zhang, Jianhua, Snelders, Eveline, Zwaan, Bas J., Schoustra, Sijmen E., Meis, Jacques F., van Dijk, Karin, Hagen, Ferry, van der Beek, Martha T., Kampinga, Greetje A., Zoll, Jan, Melchers, Willem J.G., Verweij, Paul E., Debets, Fons, Zhang, Jianhua, Snelders, Eveline, Zwaan, Bas J., Schoustra, Sijmen E., Meis, Jacques F., van Dijk, Karin, Hagen, Ferry, van der Beek, Martha T., Kampinga, Greetje A., Zoll, Jan, Melchers, Willem J.G., Verweij, Paul E., and Debets, Fons

Abstract

This study investigated the dynamics of Aspergillus fumigatus azoleresistant phenotypes in two compost heaps with contrasting azole exposures: azole free and azole exposed. After heat shock, to which sexual but not asexual spores are highly resistant, the azole-free compost yielded 98% (49/50) wild-type and 2% (1/50) azole-resistant isolates, whereas the azole-containing compost yielded 9% (4/45) wild-type and 91% (41/45) resistant isolates. From the latter compost, 80% (36/45) of the isolates contained the TR46/Y121F/T289A genotype, 2% (1/45) harbored the TR46/Y121F/M172I/T289A/G448S genotype, and 9% (4/45) had a novel pan-triazoleresistant mutation (TR46 3/Y121F/M172I/T289A/G448S) with a triple 46-bp promoter repeat. Subsequent screening of a representative set of clinical A. fumigatus isolates showed that the novel TR46 3 mutant was already present in samples from three Dutch medical centers collected since 2012. Furthermore, a second new resistance mutation was found in this set that harbored four TR46 repeats. Importantly, in the laboratory, we recovered the TR46 3 mutation from a sexual cross between two TR46 isolates from the same azole-containing compost, possibly through unequal crossing over between the double tandem repeats (TRs) during meiosis. This possible role of sexual reproduction in the emergence of the mutation was further implicated by the high level of genetic diversity of STR genotypes in the azole-containing compost. Our study confirms that azole resistance mutations continue to emerge in the environment and indicates compost containing azole residues as a possible hot spot. Better insight into the biology of environmental resistance selection is needed to retain the azole class for use in food production and treatment of Aspergillus diseases. IMPORTANCE Composting of organic matter containing azole residues might be important for resistance development and subsequent spread of resistance mutations in Aspergillus fumigatus. In this article, we

Published
2017

44. Epidemiology of Extended-Spectrum β-Lactamase-Producing E. coli and Vancomycin-Resistant Enterococci in the Northern Dutch–German Cross-Border Region

Author

Zhou, Xuewei, primary, García-Cobos, Silvia, additional, Ruijs, Gijs J. H. M., additional, Kampinga, Greetje A., additional, Arends, Jan P., additional, Borst, Dirk M., additional, Möller, Lieke V., additional, Holman, Nicole D., additional, Schuurs, Theo A., additional, Bruijnesteijn van Coppenraet, Lesla E., additional, Weel, Jan F., additional, van Zeijl, Jan H., additional, Köck, Robin, additional, Rossen, John W. A., additional, and Friedrich, Alexander W., additional

Published
2017
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45. Influenza-associated Aspergillosis in Critically Ill Patients

Author

van de Veerdonk, Frank L., primary, Kolwijck, Eva, additional, Lestrade, Pieter P. A., additional, Hodiamont, Caspar J., additional, Rijnders, Bart J. A., additional, van Paassen, Judith, additional, Haas, Pieter-Jan, additional, Oliveira dos Santos, Claudy, additional, Kampinga, Greetje A., additional, Bergmans, Dennis C. J. J., additional, van Dijk, Karin, additional, de Haan, Anton F. J., additional, van Dissel, Jaap, additional, van der Hoeven, Hans G., additional, Verweij, Paul E., additional, Rahamat-Langendoen, Janette C., additional, Kullberg, Bart-Jan, additional, Netea, Mihai G., additional, Brüggeman, Roger J., additional, Hoedemaekers, Astrid W., additional, Melchers, Willem J. G., additional, Freudenburg, Wieke, additional, Roescher, Nienke, additional, Wiersinga, W. Joost, additional, van den Berg, Charlotte H. S. B., additional, Vonk, Alieke G., additional, Tienen, Carla van, additional, Hoven, Ben van der, additional, van der Beek, Martha T., additional, Derde, Lennie P.G., additional, Leer, Coretta van, additional, Aardema, Heleen, additional, Lashof, Astrid Oude, additional, and Ang, C. Wim, additional

Published
2017
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46. A Novel Environmental Azole Resistance Mutation in Aspergillus fumigatus and a Possible Role of Sexual Reproduction in Its Emergence

Author

Zhang, Jianhua, primary, Snelders, Eveline, additional, Zwaan, Bas J., additional, Schoustra, Sijmen E., additional, Meis, Jacques F., additional, van Dijk, Karin, additional, Hagen, Ferry, additional, van der Beek, Martha T., additional, Kampinga, Greetje A., additional, Zoll, Jan, additional, Melchers, Willem J. G., additional, Verweij, Paul E., additional, and Debets, Alfons J. M., additional

Published
2017
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47. Selective reporting of antibiotic susceptibility test results in European countries: an ESCMID cross-sectional survey

Author

Pulcini, Céline, primary, Tebano, Gianpiero, additional, Mutters, Nico T., additional, Tacconelli, Evelina, additional, Cambau, Emmanuelle, additional, Kahlmeter, Gunnar, additional, Jarlier, Vincent, additional, Presterl, Elisabeth, additional, Gurbanov, Akif, additional, Piérard, Denis, additional, Uzunovic, Selma, additional, Vatcheva-Dobrevska, Rossitza, additional, Tambic, Arjana, additional, Zemlickova, Helena, additional, Skov, Robert L., additional, Naaber, Paul, additional, Hakanen, Antti, additional, Gatermann, Sören, additional, Tsakris, Athanassios, additional, Ludwig, Endre, additional, Helgason, Kristján Orri, additional, Schaffer, Kirsten, additional, Carmeli, Yehuda, additional, Sarti, Mario, additional, Raka, Lul, additional, Balode, Arta, additional, Bosevska, Golubinka, additional, Kampinga, Greetje A., additional, Lindemann, Paul Christoffer, additional, Żabicka, Dorota, additional, Alves, Valquíria, additional, Săndulescu, Oana, additional, Sukhorukova, Marina, additional, Matic, Snezana, additional, Niks, Milan, additional, Štrumbelj, Iztok, additional, Martínez-Martínez, Luis, additional, Wistedt, Annika, additional, Sax, Hugo, additional, Gür, Deniz, additional, Bamford, Kathleen B., additional, and Liashko, Viktor, additional

Published
2017
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49. Obese patients have higher rates of polymicrobial and Gram-negative early periprosthetic joint infections of the hip than non-obese patients.

Author

Löwik, Claudia A. M., Zijlstra, Wierd P., Knobben, Bas A. S., Ploegmakers, Joris J. W., Dijkstra, Baukje, de Vries, Astrid J., Kampinga, Greetje A., Mithoe, Glen, Al Moujahid, Aziz, Jutte, Paul C., Wouthuyzen-Bakker, Marjan, and null, null

Subjects
JOINT infections, HIP joint, ANTIBIOTIC prophylaxis, POSTOPERATIVE care, WOUND care
Abstract

Background: Obese patients are more likely to develop periprosthetic joint infection (PJI) after primary total joint arthroplasty. This study compared the clinical and microbiological characteristics of non-obese, obese and severely obese patients with early PJI, in order to ultimately optimize antibiotic prophylaxis and other prevention measures for this specific patient category. Methods: We retrospectively evaluated patients with early PJI of the hip and knee treated with debridement, antibiotics and implant retention (DAIR) between 2006 and 2016 in three Dutch hospitals. Only patients with primary arthroplasties indicated for osteoarthritis were included. Early PJI was defined as an infection that developed within 90 days after index surgery. Obesity was defined as a BMI ≥30kg/m2 and severe obesity as a BMI ≥35kg/m2. Results: A total of 237 patients were analyzed, including 64 obese patients (27.0%) and 62 severely obese patients (26.2%). Compared with non-obese patients, obese patients had higher rates of polymicrobial infections (60.3% vs 33.3%, p<0.001) with more often involvement of Enterococcus species (27.0% vs 11.7%, p = 0.003). Moreover, severely obese patients had more Gram-negative infections, especially with Proteus species (12.9% vs 2.3%, p = 0.001). These results were only found in periprosthetic hip infections, comprising Gram-negative PJIs in 34.2% of severely obese patients compared with 24.7% in obese patients and 12.7% in non-obese patients (p = 0.018). Conclusions: Our results demonstrate that obese patients with early periprosthetic hip infections have higher rates of polymicrobial infections with enterococci and Gram-negative rods, which stresses the importance of improving preventive strategies in this specific patient category, by adjusting antibiotic prophylaxis regimens, improving disinfection strategies and optimizing postoperative wound care. [ABSTRACT FROM AUTHOR]

Published
2019
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50. Use of gentamicin-impregnated beads or sponges in the treatment of early acute periprosthetic joint infection: a propensity score analysis.

Author

Wouthuyzen-Bakker, Marjan, Kampinga, Greetje A, Löwik, Claudia A M, Ploegmakers, Joris J W, Jutte, Paul C, Knobben, Bas A S, Zijlstra, Wierd P, Mithoe, Glen, Moujahid, Aziz Al, and Al Moujahid, Aziz

Subjects
*GENTAMICIN, *BEADS, *SPONGES (Invertebrates), *JOINT infections, *THERAPEUTICS, *DRUG therapy for arthritis, *ANTIBIOTICS, *DRUG delivery systems, *ENZYME inhibitors, *INFECTION, *COMPLICATIONS of prosthesis, *CUTANEOUS therapeutics, *TREATMENT effectiveness, *RETROSPECTIVE studies
Abstract

Objectives: Early acute periprosthetic joint infections (PJIs) treated with debridement, antibiotics and implant retention (DAIR) have failure rates ranging from 10% to 60%. We determined the efficacy of applying local gentamicin-impregnated beads and/or sponges during debridement in early PJI.Methods: Patients with early acute PJI, defined as less than 21 days of symptoms and treated with DAIR within 90 days after index surgery, were retrospectively evaluated. Early failure was defined as PJI-related death, the need for implant removal or a second DAIR or antibiotic suppressive therapy owing to persistent signs of infection, all within 60 days after initial debridement. Overall failure was defined as implant removal at any timepoint during follow-up. A 1:1 propensity score matching was performed to correct for confounding factors.Results: A total of 386 patients were included. Local gentamicin was applied in 293 patients (75.9%) and was withheld in 93 patients (24.1%). Multivariate analysis demonstrated that the use of local gentamicin was independently associated with early failure (OR = 1.97, 95% CI = 1.12-3.48). After propensity matching, early failure was 40.3% in the gentamicin group versus 26.0% in the control group (P = 0.06) and overall failure was 5.2% in the gentamicin group versus 2.6% in the control group (P = 0.40). These numbers remained when solely analysing the application of gentamicin-impregnated sponges.Conclusions: Even after propensity score matching, failure rates remained higher if local gentamicin-impregnated beads and/or sponges were administered in early acute PJI. Based on these results, their use should be discouraged. [ABSTRACT FROM AUTHOR]

Published
2018
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