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- Volume 24, Issue 34, 22/Aug/2019
Eurosurveillance - Volume 24, Issue 34, 22 August 2019
Volume 24, Issue 34, 2019
- Rapid communication
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Surveillance of vancomycin-resistant enterococci reveals shift in dominating clones and national spread of a vancomycin-variable vanA Enterococcus faecium ST1421-CT1134 clone, Denmark, 2015 to March 2019
Anette M Hammerum , Ulrik S Justesen , Mette Pinholt , Louise Roer , Hülya Kaya , Peder Worning , Sanne Nygaard , Michael Kemp , Marianne Engell Clausen , Karen Leth Nielsen , Jurgita Samulioniené , Mona Kjærsgaard , Claus Østergaard , John Coia , Turid Snekloth Søndergaard , Shahin Gaini , Kristian Schønning , Henrik Westh , Henrik Hasman and Barbara Juliane HolzknechtWe describe clonal shifts in vanA Enterococcus faecium isolates from clinical samples obtained from patients in Denmark from 2015 to the first quarter (Q1) of 2019. During Q1 2019, the vancomycin-variable enterococci (VVE) ST1421-CT1134 vanA E. faecium became the most dominant vanA E. faecium clone and has spread to all five regions in Denmark. Among 174 E. faecium isolates with vanA, vanB or vanA/vanB genes in Q1 2019, 44% belonged to this type.
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- Outbreaks
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Linked seasonal outbreaks of Salmonella Typhimurium among passerine birds, domestic cats and humans, Sweden, 2009 to 2016
In 2016, an outbreak of Salmonella Typhimurium (STm) with multilocus variable-number tandem repeat analysis (MLVA) profiles historically associated with passerine birds (2-[11-15]-[3-4]-NA-212) occurred among passerines, cats and humans in Sweden. Our retrospective observational study investigated the outbreak and revisited historical data from 2009–16 to identify seasonality, phylogeography and other characteristics of this STm variant. Outbreak isolates were analysed by whole-genome single nucleotide polymorphism (SNP) typing. The number of notified cases of passerine-associated STm among passerines, cats and humans per month and county, and their MLVA profiles, were compared to birdwatchers’ counts of passerines. Seasonal trend decomposition and correlation analysis was performed. Outbreak isolates did not cluster by host on SNP level. Passerine-associated STm was seasonal for birds, cats and humans, with a peak in March. Cases and counts of passerines at bird feeders varied between years. The incidence of passerine-associated STm infections in humans was higher in the boreal north compared with the southern and capital regions, consistent with passerine population densities. Seasonal mass migration of passerines appears to cause STm outbreaks among cats certain years in Sweden, most likely via predation on weakened birds. Outbreaks among humans can follow, presumably caused by contact with cats or environmental contamination.
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Increasing incubation periods during a prolonged monophasic Salmonella Typhimurium outbreak with environmental contamination of a commercial kitchen at Oslo Airport, Norway, 2017
In September 2017, a cluster of monophasic Salmonella Typhimurium isolates was identified at the National Reference Laboratory for Enteropathogenic Bacteria in Norway. We investigated the cluster to identify the source and implement control measures. We defined a case as a person with laboratory-confirmed salmonellosis with the outbreak strain multiple locus variable-number tandem repeat analysis type. We conducted descriptive epidemiological and environmental investigations and performed whole genome sequencing (WGS) with core and accessory genome multilocus sequence typing of all isolates from cases or the environment connected with this outbreak. We identified 21 cases, residing in 10 geographically dispersed counties, all of whom had consumed food or drinks from a café at Oslo Airport. Case distribution by date of symptom onset suggested that a point source was introduced in mid-August followed by continued environmental contamination. The incubation periods ranged 0–16 days and increased as the outbreak progressed, likely due to increasingly low-dose exposure as control measures were implemented. WGS confirmed an identical cluster type-944 in all cases and six environmental specimens from the café. Control measures, including temporary closure and kitchen refurbishment, failed to eliminate the environmental source. We recommend strengthened hygiene measures for established environmental contamination during an outbreak.
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- Surveillance
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Antimicrobial use trends, Israel, 2012 to 2017
BackgroundIn 2012, Israel’s National Center for Infection Control initiated a national stewardship programme that included mandatory annual reporting of antimicrobial use. Here we present nationwide Israeli data for the period 2012 to 2017.
AimThe goal of this study was to detect trends in antimicrobial use in Israel following the introduction of the stewardship programme, as part of an assessment of the programme’s impact.
MethodsIn this retrospective observational study, data were collected from Israel’s health maintenance organisations (HMOs), acute care hospitals and post-acute care hospitals (PACHs). Acute care hospital data were collected for general medical and surgical wards, and medical/surgical intensive care units (ICUs). Data were converted into defined daily doses (DDD), with use rates presented as DDD per 1,000 insured/day in the community and DDD per 100 patient-days in hospitals and PACHs. Trends were analysed using linear regression.
ResultsAntimicrobial use decreased across sectors between 2012 and 2017. In the community, the decrease was modest, from 22.8 to 21.8 DDD per 1,000 insured per day (4.4%, p = 0.004). In acute care hospitals, antibiotic DDDs per 100 patient-days decreased from 100.0 to 84.0 (16.0%, p = 0.002) in medical wards, from 112.8 to 94.2 (16.5%, p = 0.004) in surgical wards and from 154.4 to 137.2 (11.1%, p = 0.04) in ICUs. Antimicrobial use decreased most markedly in PACHs, from 29.1 to 18.1 DDD per 100 patient-days (37.8%, p = 0.005).
ConclusionBetween 2012 and 2017, antimicrobial use decreased significantly in all types of healthcare institutions in Israel, following the introduction of the nationwide antimicrobial stewardship programme.
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- Author's correction
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Volumes & issues
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Volume 29 (2024)
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Volume 28 (2023)
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Volume 27 (2022)
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Volume 26 (2021)
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Volume 25 (2020)
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Volume 24 (2019)
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Volume 23 (2018)
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Volume 22 (2017)
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Volume 21 (2016)
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Volume 20 (2015)
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Volume 19 (2014)
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Volume 18 (2013)
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Volume 17 (2012)
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Volume 16 (2011)
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Volume 15 (2010)
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Volume 14 (2009)
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Volume 13 (2008)
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Volume 12 (2007)
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Volume 11 (2006)
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Volume 10 (2005)
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Volume 9 (2004)
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Volume 8 (2003)
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Volume 7 (2002)
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Volume 6 (2001)
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Volume 5 (2000)
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Volume 4 (1999)
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Volume 3 (1998)
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Volume 2 (1997)
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Volume 1 (1996)
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Volume 0 (1995)
Most Read This Month
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Detection of 2019 novel coronavirus (2019-nCoV) by real-time RT-PCR
Victor M Corman , Olfert Landt , Marco Kaiser , Richard Molenkamp , Adam Meijer , Daniel KW Chu , Tobias Bleicker , Sebastian Brünink , Julia Schneider , Marie Luisa Schmidt , Daphne GJC Mulders , Bart L Haagmans , Bas van der Veer , Sharon van den Brink , Lisa Wijsman , Gabriel Goderski , Jean-Louis Romette , Joanna Ellis , Maria Zambon , Malik Peiris , Herman Goossens , Chantal Reusken , Marion PG Koopmans and Christian Drosten
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