Eurosurveillance - Volume 17, Issue 34, 23 August 2012

In April 2012, a cluster of two cases of meningococcal disease caused by rifampicin-resistant C meningococci was reported in the Champagne-Ardenne region, France. The two cases occurred in a student population living in the same town but studying at different schools. Bacteriological and epidemiological investigations of cases have shown that the isolates of both cases were non-differentiable.

Following an outbreak of enterohaemorrhagic Escherichia coli (EHEC) in Germany 2011, we observed increases in EHEC and non-EHEC E. coli cases in Bavaria. We compared the demographic, clinical and laboratory features of the cases reported during the outbreak period, but not related to the outbreak, to the cases reported before and after. The number of EHEC and non-EHEC E. coli cases notified per week during the outbreak was fivefold and twofold higher respectively, compared to previous years. EHEC cases notified during the outbreak were more often reported with bloody diarrhoea, and less often with unspecified diarrhoea, compared to the other periods. They were more often hospitalised during the outbreak and the following period compared to the period before. Their median age (26.5 years, range: 0-90) was higher compared to before (14.5 years, range: 0-94) and after (5 years, range: 0-81). The median age of non-EHEC E. coli cases notified during the outbreak period (18 years, range 0-88) was also higher than before and after (2 years, p<0.001). The surveillance system likely underestimates the incidence of both EHEC and non-EHEC E. coli cases, especially among adults, and overestimates the proportion of severe EHEC cases. Testing all stool samples from patients with diarrhoea for enteropathic E. coli should be considered. .

HAIs (healthcare-associated infections) are likely to become an increasing public health problem. Therefore, a point-prevalence study called HALT (Healthcare-associated infections in long-term-care facilities) was set up by the European Centre for Disease Prevention and Control to determine the prevalence, antibiotic use and determinants associated with HAIs. In the Netherlands, 10 nursing homes (in total 1,429 elderly residents) participated in the study between May and June 2010. Risk and protective factors were determined by calculating relative risks (RRs) and performing multilevel Poisson regression. An overall infection prevalence of 2.8% was found and 3.5% of the residents used antibiotics. Residents' characteristics such as the presence of pressure wounds (RR: 2.58; 95% CI: 1.04-6.39) and other wounds (RR: 5.70; 95% CI: 2.99-10.86) were risk factors for an HAI, whereas being male (RR: 0.43; 95% CI: 0.21-0.91) was protective. Nursing home characteristics, such as the percentage of shared rooms (≥32%) (RR: 0.49; 95% CI: 0.39-0.62) and percentage of incontinent residents (≥63%) (RR: 0.72; 95% CI: 0.61-0.85) were protective determinants in a multivariate analysis. Special attention is therefore needed for female residents and residents with pressure and other wounds for the prevention of HAIs in Dutch nursing homes. .