%0 Report %D 2024 %T RESULTATEN VAN DE 10E NATIONALE CAMPAGNE TER BEVORDERING VAN HANDHYGIENE IN BELGISCHE ZIEKENHUIZEN %A Matijs Houben %A Katelijne Matthys %A Louise Vaes %A Boudewijn Catry %K Campagne %K handhygiëne in ziekenhuizen %I Sciensano %C Brussel, België %P 24 %8 03/2024 %G eng %U https://www.sciensano.be/nl/projecten/campagne-voor-handhygiene %M D/2024.440/23 %0 Report %D 2024 %T RÉSULTATS DE LA 10ÈME CAMPAGNE NATIONALE DE PROMOTION DE L'HYGIÈNE DES MAINS DANS LES HÔPITAUX BELGES %A Matijs Houben %A Katelijne Matthys %A Louise Vaes %A Boudewijn Catry %K Campagne %K Hand hygiene %I Sciensano %C Bruxelles, Belgique %P 24 %8 03/2024 %G eng %U https://www.sciensano.be/fr/surveillance-nationale-des-infections-dans-les-etablissements-de-soins-de-sante-nsih %M D/2024.440/22 %0 Government Document %D 2024 %T Trends in Hospital Antibacterial Consumption in Belgium (2017-2021): Evaluating the Impact of the COVID-19 Pandemic %A Laura Bonacini %A Elena Damian %A Boudewijn Catry %A Lucy Catteau %K antimicrobial consumption %K Belgian hospitals %X

This study aimed to evaluate the impact of the COVID-19 pandemic on antimicrobial consumption (AMC) in Belgian hospitals from 2017 to 2021, using data from the European Surveillance of Antimicrobial Consumption Network (ESAC-Net) and the Belgian Hospitals Surveillance of Antimicrobial Consumption (BeH-SAC).

Antimicrobial volume was quantified in Defined Daily Doses (DDDs), and AMC was expressed in DDDs/1000 inhabitants/day (DIDs), DDDs/1000 patient days and DDDs/1000 admissions. Linear regressions were employed to analyze 5-year trends for the ATC J01 group, at the ATC-3 level and for broad-spectrum antimicrobials. Broad-spectrum antibiotics included combinations of penicillins, incl. beta-lactamase inhibitors (J01CR), second-generation cephalosporins (J01DC), third-generation cephalosporins (J01DD), macrolides, lincosamides and streptogramins (J01F, excluding erythromycin J01FA01), and fluoroquinolones (J01MA). The compound annual growth rate (CAGR) calculated for the years preceding the pandemic was used to forecast 2020 and 2021 AMC, enabling a comparison with the actual use.

Hospital AMC measured as DIDs decreased by 12% from 2019 to 2020. In contrast, when expressed as DDDs/1000 patient days and DDDs/1000 admissions, a 5% and 7% increase was observed, respectively. Antibacterials for systemic use (J01) showed a significant decrease over the 5 years only when expressed in DIDs. Notable trends included a negative trend for quinolone antibacterials (J01M) when expressed in the three incidence units, as for amphenicols (J01B) when using hospital denominators only. Positive trends were observed for sulfonamides and trimethoprim (J01E) using hospital denominators, and for other beta-lactam antibacterials (J01D) with the ‘patient days’ denominator. While the consumption of all J01 antimicrobial subclasses deviated negatively from predicted use both in 2020 and 2021 when expressed in DIDs, positive deviations were recorded using hospital denominators, except for macrolides (J01F). The use of broad-spectrum antimicrobials showed a notable decrease between 2017 and 2021 when expressed in DIDs. However, when using hospital denominators, the observed use of broad-spectrum antimicrobials exceeded the forecasted values in 2020, to regress below the forecasted levels in 2021 (Figure 1).

Contrary to results obtained using the widely applied country’s population as the denominator, a notable surge in AMC, particularly for broad-spectrum antimicrobials, was observed in 2020 when using hospital-specific denominators. This increase coincided with the onset of the COVID-19 crisis. These findings emphasize the need for a national hospital surveillance system that uses denominators that accurately represent the specific population being monitored. Implementing robust hospital-specific surveillance mechanisms would improve the precision of evaluations and facilitate targeted interventions aimed at optimizing antimicrobial utilization.

%B SHEA Spring Conference %I SHEA %C Houston, Texas %8 2024 %G eng %0 Generic %D 2023 %T Antimicrobial monitoring in nursing homes: a target for antimicrobial stewardship %A Moira Kelly %A Boudewijn Catry %A Lucy Catteau %K antimicrobial consumption %K long term care facilities %I ICPIC %C Geneva, Switzerland %8 sep 2023 %G eng %0 Government Document %D 2023 %T Antimicrobiële consumptie in België: resultaten van de ESAC-Net en BeH-SaC monitoring %A Lucy Catteau %A Moira Kelly %A Laura Bonacini %A Boudewijn Catry %B nosoinfo %V XXVII %P 41 %8 August 2023 %G eng %N 2 %& 12 %0 Generic %D 2023 %T Assessing Antimicrobial Consumption in Belgian Nursing Homes (2016-2022): A First-Time National Surveillance Study %A Moira Kelly %A Boudewijn Catry %A Lucy Catteau %K antimicrobial consumption %K long term care facilities %I ESCAIDE 2023 %C Barcelona, Spain %8 Nov 2023 %G eng %0 Report %D 2023 %T BeH-SAC Protocol 2023 - BELGIAN HOSPITALS – SURVEILLANCE OF ANTIMICROBIAL CONSUMPTION %A Lucy Catteau %A Laura Bonacini %A Boudewijn Catry %G eng %0 Report %D 2023 %T BEH-SAC Protocol 2023 - BELGISCHE ZIEKENHUIZEN - MONITORING VAN ANTIMICROBIËLE CONSUMPTIE %A Lucy Catteau %A Laura Bonacini %A Boudewijn Catry %G eng %0 Government Document %D 2023 %T Consommation d’antimicrobiens en Belgique : résultats des surveillances ESAC-Net et BeH-SAC %A Lucy Catteau %A Moira Kelly %A Laura Bonacini %A Boudewijn Catry %B nosoinfo %V XXVII %P 41 %8 Août 2023 %G eng %N 2 %& 12 %0 Journal Article %J Viruses %D 2023 %T COVID-19 Clusters in Belgian Nursing Homes: Impact of Facility Characteristics and Vaccination on Cluster Occurrence, Duration and Severity %A Sara Dequeker %A Milena Callies %A Lucy Catteau %A Laura Int Panis %A Esma Islamaj %A Sofieke Klamer %A Katrien Latour %A Marijke Pauwels %A Catharina Vernemmen %A Romain Mahieu %A Hanna Masson %A Muhammet Savsin %A Etienne Clercq %A Mireille Thomas %A Boudewijn Catry %A Eline Vandael %K clusters %K infection prevention %K long-term care facilities %K SARS-CoV-2 %K Vaccination %X

COVID-19 severely affected nursing home residents from March 2020 onwards in Belgium. This study aimed to model the impact of vaccination and facility characteristics on cluster occurrence, duration and severity in this setting. Possible clusters were identified between June 2020 and January 2022, based on the Belgian COVID-19 surveillance in nursing homes. Median attack rates (AR) among residents and staff, case hospitalization rates (CHR) and case fatality rates (CFR) were calculated. A negative binomial model was used to identify the association between nursing home characteristics and the number of cases, hospital admissions and deaths and the duration of the cluster. A total of 2,239 clusters were detected in more than 80% of nursing homes. Most of these (62%) occurred before the start of COVID-19 vaccination (end of December 2020). After vaccination, the number of clusters, the AR among residents and staff, the CHR and the CFR dropped. Previous cluster(s) and vaccination decreased the number of cases, hospital admissions and deaths among residents. Previous cluster experience and having started vaccination were protective factors. We recommend continued implementation of targeted interventions such as vaccination, large-scale screening and immediate implementation of additional infection prevention and control measures.

%B Viruses %V 15 %8 Jan-01-2023 %G eng %N 1 %R 10.3390/v15010232 %0 Journal Article %J Nature Aging %D 2023 %T Immunovirological and environmental screening reveals actionable risk factors for fatal COVID-19 during post-vaccination nursing home outbreaksAbstract %A Lize Cuypers %A Els Keyaerts %A Samuel Leandro Hong %A Sarah Gorissen %A Soraya Maria Menezes %A Marick Starick %A Jan Van Elslande %A Matthias Weemaes %A Tony Wawina-Bokalanga %A Joan Marti-Carreras %A Bert Vanmechelen %A Bram Van Holm %A Mandy Bloemen %A Jean-Michel Dogne %A Keith Durkin %A Jean Ruelle %A Elke Wollants %A Pieter Vermeersch %A Wattiez, Ruddy %A Michael Peeters %A Kate Bakelants %A Sarah Denayer %A François Dufrasne %A Cécile Meex %A Gillet, Laurent %A Maria Artesi %A Marie-Pierre Hayette %A Sébastien Bontems %A Vincent Bours %A Claire Gourzonès %A Olivier Ek %A Bureau, Fabrice %A Kabamba, Benoît %A Jean-Luc Gala %A Bertrand Bearzatto %A Ambroise, Jérôme %A Arnaud Marchant %A Coralie Henin %A Benoit Haerlingen %A Ricardo De Mendonca %A Delforge, Marie-Luce %A Carl Vael %A Lynsey Berckmans %A Philippe Selhorst %A Kevin K. Ariën %A Sonia Van Dooren %A Bruno Hinckel %A Hideo Imamura %A Toon Janssen %A Ben Caljon %A Oriane Soetens %A Piérard, Denis %A Thomas Demuyser %A Charlotte Michel %A Vandenberg, Olivier %A Van den Wijngaert, Sigi %A Giulia Zorzi %A Philippe Van Lint %A Walter Verstrepen %A Reinout Naesens %A Sarah Van Lent %A Pascale Hilbert %A Sylvain Brohée %A Pierre-Emmanuel Léonard %A Deniz Karadurmus %A Jeremie Gras %A Damien Féret %A Barbara Lambert %A Vankeerberghen, Anne %A Astrid Holderbeke %A De Beenhouwer, Hans %A Cattoir, Lien %A Christine Lammens %A Xavier, Basil Britto %A Marie Le Mercier %A Jasmine Coppens %A Veerle Matheeussen %A Goossens, Herman %A Geert A. Martens %A Koen Swaerts %A Van Hoecke, Frederik %A Dieter Desmet %A Patrick Descheemaeker %A Bogaerts, Pierre %A Jonathan Degosserie %A Denis, Olivier %A Huang, Te-Din %A Dagmar Obbels %A Hanne Valgaeren %A Frans, Johan %A Annick Smismans %A Paul-Emile Claus %A Denise Veltman %A Truus Goegebuer %A Ann Lemmens %A Bea Van den Poel %A Sonja De Bock %A Laffut, Wim %A Ellen Van Even %A Van Acker, Jos %A Charlotte Verfaillie %A Elke Vanlaere %A De Rauw, Klara %A Luc Waumans %A Britt Van Meensel %A Reinoud Cartuyvels %A Marijke Raymaekers %A Bruno Verhasselt %A Jorn Hellemans %A Merijn Vanhee %A Marijke Reynders %A Caroline Boulouffe %A Achille Djiena %A Caroline Broucke %A Boudewijn Catry %A Lagrou, Katrien %A Van Ranst, Marc %A Neyts, Johan %A Guy Baele %A Piet Maes %A Emmanuel André %A Simon Dellicour %A Johan Van Weyenbergh %B Nature Aging %8 Oct-05-2024 %G eng %R 10.1038/s43587-023-00421-1 %0 Journal Article %J Journal of Antimicrobial Chemotherapy %D 2023 %T Impact of the COVID-19 pandemic on community antibiotic consumption in the EU/European Economic Area: a changepoint analysis %A Helene Vermeulen %A Hens, Niel %A Lucy Catteau %A Boudewijn Catry %A Coenen, Samuel %B Journal of Antimicrobial Chemotherapy %V 78 %8 Jun-09-2023 %G eng %N 10 %R 10.1093/jac/dkad273 %0 Report %D 2023 %T Protocole BeH-SAC 2023 - HÔPITAUX BELGES - SURVEILLANCE DE LA CONSOMMATION D'ANTIMICROBIENS %A Lucy Catteau %A Laura Bonacini %A Boudewijn Catry %G eng %0 Generic %D 2023 %T Unequal progress towards national antimicrobial consumption targets in the ambulatory care sector in Belgium: A 2012-2021 longitudinal study including the COVID-19 era %A Moira Kelly %A Laura Bonacini %A Boudewijn Catry %A Lucy Catteau %K antimicrobial consumption %I AMCRA %C Brussels, Belgium %8 2023 %G eng %0 Thesis %D 2023 %T Urinary tract infections in nursing home residents: Understanding the epidemiology and the clinical diagnosis and management %A Katrien Latour %A Jan De Lepeleire %A Frank Buntinx %A Boudewijn Catry %K long-term care facilities; healthcare-associated infections; antimicrobial use %I KU Leuven %C Leuven, Belgium %P 168 %8 08/09/2023 %@ 9789075828382 %G eng %0 Journal Article %J Archives of Public Health %D 2022 %T COVID-19 cases, hospitalizations and deaths in Belgian nursing homes: results of a surveillance conducted between April and December 2020 %A Eline Vandael %A Katrien Latour %A Esma Islamaj %A Laura Int Panis %A Milena Callies %A Freek Haarhuis %A Kristiaan Proesmans %A Brecht Devleesschauwer %A Javiera Rebolledo %A Alice Hannecart %A Romain Mahieu %A Louise De Viron %A Etienne De Clercq %A Anne Kongs %A Naïma Hammami %A Jean-Marc François %A Dominique Dubourg %A Sarah Henz %A Boudewijn Catry %A Sara Dequeker %X

BACKGROUND: In Belgium, the first COVID-19 death was reported on 10 March 2020. Nursing home (NH) residents are particularly vulnerable for COVID-19, making it essential to follow-up the spread of COVID-19 in this setting. This manuscript describes the methodology of surveillance and epidemiology of COVID-19 cases, hospitalizations and deaths in Belgian NHs.

METHODS: A COVID-19 surveillance in all Belgian NHs (n = 1542) was set up by the regional health authorities and Sciensano. Aggregated data on possible/confirmed COVID-19 cases and hospitalizations and case-based data on deaths were reported by NHs at least once a week. The study period covered April-December 2020. Weekly incidence/prevalence data were calculated per 1000 residents or staff members.

RESULTS: This surveillance has been launched within 14 days after the first COVID-19 death in Belgium. Automatic data cleaning was installed using different validation rules. More than 99% of NHs participated at least once, with a median weekly participation rate of 95%. The cumulative incidence of possible/confirmed COVID-19 cases among residents was 206/1000 in the first wave and 367/1000 in the second wave. Most NHs (82%) reported cases in both waves and 74% registered ≥10 possible/confirmed cases among residents at one point in time. In 51% of NHs, at least 10% of staff was absent due to COVID-19 at one point. Between 11 March 2020 and 3 January 2021, 11,329 COVID-19 deaths among NH residents were reported, comprising 57% of all COVID-19 deaths in Belgium in that period.

CONCLUSIONS: This surveillance was crucial in mapping COVID-19 in this vulnerable setting and guiding public health interventions, despite limitations of aggregated data and necessary changes in protocol over time. Belgian NHs were severely hit by COVID-19 with many fatal cases. The measure of not allowing visitors, implemented in the beginning of the pandemic, could not avoid the spread of SARS-CoV-2 in the NHs during the first wave. The virus was probably often introduced by staff. Once the virus was introduced, it was difficult to prevent healthcare-associated outbreaks. Although, in contrast to the first wave, personal protective equipment was available in the second wave, again a high number of cases were reported.

%B Archives of Public Health %V 80 %8 Jan-12-2022 %G eng %N 1 %R 10.1186/s13690-022-00794-6 %0 Report %D 2022 %T Etude de prévalence ponctuelle des infections liées aux soins et de l’usage d’antimicrobiens dans les établissements de long séjour (HALT 2021) %A Laura Int Panis %A Katrien Latour %A Boudewijn Catry %K antimicrobial use %K healthcare-associated infections %I Sciensano %C Brussels, Belgium %P 30 %8 06/01/2023 %G eng %M D/2022/14.440/69 %0 Journal Article %J Archives of Public Health %D 2022 %T Healthcare-associated infections and antimicrobial use in Belgian nursing homes: results of three point prevalence surveys between 2010 and 2016 %A Katrien Latour %A Boudewijn Catry %A Brecht Devleesschauwer %A Frank Buntinx %A Jan De Lepeleire %A Beatrice Jans %K Anti-Bacterial Agents %K cross-sectional studies %K INFECTION %K Infection Control %K long-term care %K nursing homes %X

Background

Belgium monitors the burden of healthcare-associated infections (HAIs) and antimicrobial use in nursing homes (NHs) by participating in the European point prevalence surveys (PPSs) organised in long-term care facilities (HALT surveys). We present the main findings of the three national PPSs conducted in NHs participating in at least one of these surveys, and in a cohort that participated in all three consecutive surveys.

Methods

All NHs were invited to voluntarily participate and conduct the survey on one single day in May-September 2010 (HALT-1), in April-May 2013 (HALT-2) or in September-November 2016 (HALT-3). Data were collected at institutional, ward and resident level. A detailed questionnaire had to be completed for all eligible (i.e. living full time in the facility since at least 24 h, present at 8:00 am and willing to participate) residents receiving at least one systemic antimicrobial agent and/or presenting at least one active HAI on the PPS day. The onset of signs/symptoms had to occur more than 48 h after the resident was (re-)admitted to the NH.

Results

A total of 107, 87 and 158 NHs conducted the HALT-1, HALT-2 and HALT-3 survey, respectively. The median prevalence of residents with antimicrobial agent(s) increased from 4.3% (95% confidence interval (CI): 3.5-4.8%) in HALT-1 to 4.7% (95% CI: 3.5-6.5%) in HALT-2 and 5.0% (95% CI: 4.2-5.9%) in HALT-3. The median prevalence of residents with HAI(s) varied from 1.8% (95% CI: 1.4-2.7%) in HALT-1 to 3.2% (95% CI: 2.2-4.2%) in HALT-2 and 2.7% (95% CI: 2.1-3.4%) in HALT-3. Our post-hoc analysis on the cohort (n = 25 NHs) found similar trends. In all three surveys, respiratory tract infections were most frequently reported, followed by skin/wound infections in HALT-1 and urinary tract infections in HALT-2 and HALT-3. Antimicrobials were most commonly prescribed for the therapeutic treatment of an infection: 66.4% in HALT-1, 60.9% in HALT-2 and 64.1% in HALT-3. Uroprophylaxis accounted for 28.7%, 35.6% and 28.4% of all prescriptions, respectively.

Conclusions

None withstanding the limitations peculiar to the study design, the PPSs enabled us to assess the occurrence of and to increase awareness for HAIs and rational antimicrobial use in NHs at both local and national level.

%B Archives of Public Health %V 80 %8 Jan-12-2022 %G eng %N 1 %R 10.1186/s13690-022-00818-1 %0 Journal Article %J International Journal of Antimicrobial Agents %D 2022 %T MRSA surveillance programmes worldwide: moving towards a harmonised international approach %A Valérie O. Baede %A Michael Z. David %A Arjana Tambić Andrašević %A Dominique S. Blanc %A Michael Borg %A Brennan, Grainne %A Boudewijn Catry %A Aurélie Chabaud %A Joanna Empel %A Hege Enger %A Hallin, Marie %A Marina Ivanova %A Andreas Kronenberg %A Kuntaman, Kuntaman %A Anders Rhod Larsen %A Katrien Latour %A Jodi A. Lindsay %A Bruno Pichon %A Dewi Santosaningsih %A Leo M. Schouls %A François Vandenesch %A Guido Werner %A Dorota Żabicka %A Helena Žemličková %A Harald Seifert %A Margreet C. Vos %K Antimicrobial resistance %K epidemiology %K Staphylococcus aureus %X

Multinational surveillance programmes for methicillin-resistant Staphylococcus aureus (MRSA) are dependent on national structures for data collection. This study aimed to capture the diversity of national MRSA surveillance programmes and to propose a framework for harmonisation of MRSA surveillance. The International Society of Antimicrobial Chemotherapy (ISAC) MRSA Working Group conducted a structured survey on MRSA surveillance programmes and organised a webinar to discuss the programmes' strengths and challenges as well as guidelines for harmonisation. Completed surveys represented 24 MRSA surveillance programmes in 16 countries. Several countries reported separate epidemiological and microbiological surveillance. Informing clinicians and national policy-makers were the most common purposes of surveillance. Surveillance of bloodstream infections (BSIs) was present in all programmes. Other invasive infections were often included. Three countries reported active surveillance of MRSA carriage. Methodology and reporting of antimicrobial susceptibility, virulence factors, molecular genotyping and epidemiological metadata varied greatly. Current MRSA surveillance programmes rely upon heterogeneous data collection systems, which hampers international epidemiological monitoring and research. To harmonise MRSA surveillance, we suggest improving the integration of microbiological and epidemiological data, implementation of central biobanks for MRSA isolate collection, and inclusion of a representative sample of skin and soft-tissue infection cases in addition to all BSI cases.

%B International Journal of Antimicrobial Agents %V 59 %8 Jan-03-2022 %G eng %N 3 %R 10.1016/j.ijantimicag.2022.106538 %0 Journal Article %J BMC Geriatrics %D 2022 %T Nursing home residents with suspected urinary tract infections: a diagnostic accuracy study %A Katrien Latour %A Jan De Lepeleire %A Boudewijn Catry %A Buntinx, Frank %K Aged; Long-term care; Point-of-care testing; Urinary tract infections %X

Background: Urinary tract infections (UTIs) are one of the most common infections in nursing homes (NHs). A high error rate of a UTI diagnosis based solely on clinical criteria is to be expected in older persons as they often present infections in an atypical way. A study was set up to assess the diagnostic value of signs/symptoms and urine dipstick testing in identifying UTIs in NH residents and to explore whether C-reactive protein (CRP) measured by point-of-care testing (POCT) can help in the diagnosis.

Methods: During a three month prospective multicentre study, urine sampling for culture, POCT CRP and urinary dipstick testing were performed in each NH resident with a suspected UTI. UTIs were defined according to Stone et al., i.e. criteria based upon the presence of a set of signs/symptoms and a positive urine culture.

Results: Eleven NHs and 1 263 residents participated. Sixteen out of 137 recorded UTI suspicions were confirmed. Acute dysuria (positive likelihood ratio (LR +): 7.56, 95% confidence interval (CI): 3.94-14.5) and acute suprapubic pain (LR + : 11.4, 95% CI: 3.58-35.9) were found to be significant predictors. The combined nitrite and leucocyte esterase urine dipstick test (one or both positive) had a 96.0% negative predictive value (95% CI: 80.5-99.3%). The sensitivity of a positive CRP test (≥ 5 mg/L) was 60.0% (95% CI: 32.3-83.7%). Antimicrobials were prescribed in 60.2% of suspected but unconfirmed UTIs and in 92.3% of confirmed UTIs.

Conclusions: Using a stringent definition, only 11.7% of our suspicions were confirmed. Besides acute dysuria and suprapubic pain, we were not able to prove that any other clinical sign/symptom or POCT CPR adds useful information to the UTI diagnosis. We confirmed the findings of earlier research that urine dipstick tests are useful in ruling out UTIs and identified a potential overuse of antimicrobials in our NH population.

%B BMC Geriatrics %V 22 %8 Jan-12-2022 %G eng %N 1 %R 10.1186/s12877-022-02866-2 %0 Report %D 2022 %T Puntprevalentiestudie van zorginfecties en antimicrobieel gebruik in chronische zorginstellingen (HALT 2021) %A Laura Int Panis %A Katrien Latour %A Boudewijn Catry %K antimicrobial use %K Healthcare-associated infection %I Sciensano %C Brussels, Belgium %P 30 %8 06/01/2023 %G eng %M D/2022/14.440/70 %0 Report %D 2022 %T Resultaat van de quiz "De stem van de patïent & Bezoeker in 2022" %A Nathalie Shodu %A P. Polpettini %A Boudewijn Catry %E A Simon %E A. Willemse %E F. De Meerleer %E A. Spettante %E P. Taminiau %E A. Metango %E F. Antoine %E J. Louis %E C. Haesbroek %E C. Van Muijlder %E E. Croquet %E G. Demaiter %E K. Buelens %E K. Beirens %E M. El Fassi %E V. Blomme %K Hand hygiene %K onderzoek %K quiz %I Sciensano %C Bruxelles, Belgique %P 21 %8 18/11/22 %G eng %M D/2022/14.440/60 %0 Report %D 2022 %T Résultat du quizz " La voix du patient & visiteur en 2022" %A Nathalie Shodu %A P. Polpettini %A Boudewijn Catry %E A. Simon %E A. Willemse %E F. De Meerleer %E A. Spettante %E P. Taminiau %E A. Metango %E F. Antoine %E J. Louis %E C. Haesbroek %E C. Van Muijlder %E E. Croquet %E G. Demaiter %E K. Buelens %E K. Beirens %E M. El Fassi %E V. Blomme %K Enquête %K onderzoek %K quiz %K survey %I Sciensano %C Bruxelles, Belgique %P 22 %8 18/11/2022 %G eng %M D/2022/14.440/61 %0 Report %D 2022 %T Resultaten van de 9e nationale campagne ter bevordering van de handhygiëne in de ziekenhuizen, versie 1.0 %A Nathalie Shodu %A P. Polpettini %A Boudewijn Catry %A A. Simon %A A. Willemse %A F. De Meerleer %A A. Spettante %A P. Taminiau %A A. Metango %A F. Antoine %A C. Haesbroek %A C. Van Muijlder %A E. Croquet %A G. Demaiter %A J. Louis %A K. Buelens %A K. Beirens %A M. El Fassi %A V. Blomme %K Campagne %K handhygiëne in ziekenhuizen %I Sciensano %C Brussel %P 60 %8 05/2022 %G eng %M D/2022.14.440/30 %0 Report %D 2022 %T RÉSULTATS DE LA 7E CAMPAGNE NATIONALE DE PROMOTION DE L'HYGIÈNE DES MAINS DANS LES HÔPITAUX DU GRAND-DUCHÉ DU LUXEMBOURG_2021 %A Nathalie Shodu %A P. Polpettini %A Louise Vaes %A Boudewijn Catry %E E. Gelhausen %K Campagne %K Hand hygiene %K hygiène des mains %I Sciensano %C Bruxelles, Belgique %P 26 %8 18/11/2022 %G eng %M D/2022.14.440/62 %0 Report %D 2022 %T Résultats de la 7e campagne nationale de promotion de l'hygiène des mains dans les hôpitaux du Grand-Duché du Luxembourg 2021 %A Nathalie Shodu %A Paola Polpettini %A Louise Vaes %A Boudewijn Catry %A Eliane Gelhausen %K Hand hygiene %K hygiène des mains %I Sciensano %C Bruxelles, Belgique %P 26 %8 Mai 2022 %G eng %0 Report %D 2022 %T Résultats de la 9è campagne nationale de promotion de l’hygiène des mains dans les hôpitaux ,Belgique 2020-2021, version 1.0 %A Nathalie Shodu %A P. Polpettini %A Boudewijn Catry %E A. Simon %E A. Willemse %E F. De Meerleer %E A. Spettante %E P. Taminiau %E A. Metango %E F. Antoine %Y C. Haesbroek %Y C. Van Muijlder %Y E. Croquet %Y G. Demaiter %Y J. Louis %Y K. Buelens %Y K. Beirens %Y M. El Fassi %Y V. Blomme %K Campagne %K hygiène des mains %I Sciensano %C Bruxelles %P 66 %8 05/2022 %G eng %M D/2022.14.440/29 %0 Report %D 2022 %T Résultats de la campagne nationale pour la promotion de l'hygiene des mains dans les hôpitaux du Grand-Duche du Luxembourg (2019) %A H De Pauw %A Nathalie Shodu %A N. Benhammadi %A Louise Vaes %A Boudewijn Catry %E E. Gelhausen %K Campagne %K Hand hygiene %K hygiène des mains %I Sciensano %C Bruxelles, Belgique %P 26 %8 17/11/2022 %G eng %M D/2022/14.440/58 %R http://x %0 Report %D 2021 %T Antimicrobial Consumption in Belgium: 10-year evolution (2010-2019) in the community, nursing homes and hospitals %A Eline Vandael %A Katrien Latour %A Boudewijn Catry %K antimicrobial consumption %K Belgium %I Sciensano %C Brussels %P 89 %8 2021-03-29 %G eng %M D/2021/14.440/10 %0 Report %D 2021 %T Protocol COVID-19 Surveillance in residential institutions - version 5.2 %A Sara Dequeker %A Katrien Latour %A Esma Islamaj %A Laura Int Panis %A Milena Callies %A Lucy Catteau %A Boudewijn Catry %A Natalia Bustos Sierra %A Françoise Renard %A Eline Vandael %I Sciensano %C Brussels, Belgium %P 17 %8 02/07/2021 %G eng %0 Report %D 2021 %T Protocol COVID-19 surveillance in residentiële instellingen - versie 5.2 %A Sara Dequeker %A Katrien Latour %A Esma Islamaj %A Laura Int Panis %A Milena Callies %A Lucy Catteau %A Boudewijn Catry %A Natalia Bustos Sierra %A Françoise Renard %A Eline Vandael %G eng %0 Report %D 2021 %T Protocole surveillance COVID-19 dans les institutions résidentiels - version 5.2 %A Sara Dequeker %A Katrien Latour %A Esma Islamaj %A Laura Int Panis %A Milena Callies %A Lucy Catteau %A Boudewijn Catry %A Natalia Bustos Sierra %A Françoise Renard %A Eline Vandael %P 19 %8 01/06/2021 %G eng %0 Journal Article %J Acta Clin Belg %D 2020 %T Antibiotic use and resistance in Belgium: the impact of two decades of multi-faceted campaigning. %A R Bruyndonckx %A Coenen, S %A N Hens %A Eline Vandael %A Boudewijn Catry %A Goossens, H %X

: To present an overview of almost two decades of multi-faceted campaigning by the Belgian Antibiotic Policy Coordination Committee (BAPCOC) and partners, and its impact on public and prescribers' awareness, outpatient antibiotic use, its cost and antimicrobial resistance in Belgium.: Awareness of both public and prescribers was assessed through pre- and post-campaign interviews and surveys. Outpatient antibiotic use was evaluated using national reimbursement data expressed in number of defined daily doses and packages (a good proxy for treatments) per 1000 inhabitants per day (DID and PID, respectively) from July 1997 to June 2018. Its cost was studied using the same data expressed in number of euros per 1000 inhabitants per day. Antimicrobial resistance was evaluated between 1986 and 2017 using national data on the proportion of Streptococcus pneumoniae isolates not susceptible to penicillins, macrolides and tetracyclines.: Antibiotic awareness improved significantly, with general practitioners preferred by 87.5% of respondents as source of information. The Belgian outpatient antibiotic use has decreased by 12.8% in DID and by 42.8% in PID in the 2017-2018 winter compared to the winter before the start of its public awareness campaigns (1999-2000). This evolution coincided with decreasing costs for antibiotics and decreasing antimicrobial resistance. Despite multi-faceted campaigning, outpatient antibiotic use and use of broad-spectrum antibiotics, especially fluoroquinolones and amoxicillin with clavulanic acid, are still high in Belgium.: Almost two decades of multi-faceted campaigning coincide with improvements in antibiotic awareness among the public and prescribers, outpatient antibiotic use and resistance. Nevertheless, additional efforts are needed to reach the targets set in BAPCOC's national action plan 2014-2019. Therefore, a new national action plan was developed for 2020-2024 using a One Health approach.

%B Acta Clin Belg %8 2020 Feb 05 %G eng %R 10.1080/17843286.2020.1721135 %0 Journal Article %J Journal of Infection Prevention %D 2020 %T Diagnosis, prevention and control of urinary tract infections: a survey of routine practices in Belgian nursing homes %A Katrien Latour %A Jan De Lepeleire %A Béatrice Jans %A Buntinx, Frank %A Boudewijn Catry %K Aged %K long-term care %K prevention and control %K urinary catheterisation %K Urinary Tract Infections %K urine specimen collection %X

Background:

Urinary tract infections (UTIs) are one of the most frequently reported infections in older adults and the most common reason for antimicrobial prescribing in nursing homes (NHs). In this vulnerable population, both a good diagnosis and prevention of these infections are crucial as overuse of antibiotics can lead to a variety of negative consequences including the development of multidrug-resistant organisms.

Objective:

To determine infection prevention and control (IPC) and diagnostic practices for UTIs in Belgian NHs.

Methods:

Local staff members had to complete an institution-level questionnaire exploring the availability of IPC practices and resources and procedures for UTI surveillance, diagnosis, and urinary catheter and incontinence care.

Results:

UTIs were the second most common infections in the 87 participating NHs (prevalence: 1.0%). Dipstick tests and urine cultures were routinely performed in 30.2% and 44.6% of the facilities, respectively. In non-catheterised residents, voided or midstream urine sampling was most frequently applied. Protocols/guidelines for urine sampling, urinary catheter care and incontinence care were available in 43.7%, 45.9% and 31.0% of the NHs, respectively. Indwelling catheters were uncommon (2.3% of the residents) and urinary retention (84.9%) and wound management (48.8%) were the most commonly reported indications. Only surveillance was found to significantly impact the UTI prevalence: 2.2% versus 0.8% in NHs with or without surveillance, respectively (P < 0.001).

Discussion:

This survey identified key areas for improving the diagnosis and prevention of UTIs, such as education and training regarding the basics of urine collection and catheter care.

%B Journal of Infection Prevention %8 Dec-06-2020 %G eng %R 10.1177/1757177420921914 %0 Journal Article %J Journal of Antimicrobial Chemotherapy %D 2020 %T Fluoroquinolone resistance in Escherichia coli isolates after exposure to non-fluoroquinolone antibiotics: a retrospective case–control study %A Linda E Chaname Pinedo %A Bruyndonckx, Robin %A Boudewijn Catry %A Katrien Latour %A Goossens, Herman %A Steven Abrams %A Coenen, Samuel %K antibiotics %K Belgium %K Escherichia coli %K Fluoroquinolones %K Nitrofurantoin %K Trimethoprim-Sulfamethoxazole Combination %K urine specimens %X

Objectives

To investigate whether prior exposure to non-fluoroquinolone antibiotics increases the risk of fluoroquinolone resistance in Escherichia coli.

Methods

This was a secondary analysis of data collected retrospectively in a case–control study linking microbiological test results (isolated bacteria and their susceptibility) of urine samples routinely collected from primary, secondary and tertiary care patients in Belgium with information on prior antibiotic use at the patient level up to 1 year previously.

Results

In urine samples from 6125 patients, 7204 E. coli isolates were retrieved [1949 fluoroquinolone-resistant isolates (cases) and 5255 fluoroquinolone-susceptible isolates (controls)]. After adjusting for potential confounders (including fluoroquinolone use) and correcting for multiple testing there were lower odds of fluoroquinolone resistance in E. coli isolates after exposure to cefazolin (OR = 0.65; 95% CI = 0.52–0.81; P = 0.00014) and higher odds after exposure to trimethoprim/sulfamethoxazole (OR = 1.56; 95% CI = 1.23–1.97; P =0.00020) or nitrofurantoin (OR = 1.50; 95% CI = 1.23–1.84; P =0.000083). A sensitivity analysis excluding samples with antibiotic use during the 6 months prior to the sampling date confirmed the higher odds of fluoroquinolone resistance after exposure to trimethoprim/sulfamethoxazole and nitrofurantoin.

Conclusions

Assuming no residual confounding or other biases, this study suggests that exposure to non-fluoroquinolone antibiotics, i.e. trimethoprim/sulfamethoxazole and nitrofurantoin, might be causally related to fluoroquinolone resistance in E. coli isolates from urinary samples. Future prospective research is needed to confirm non-fluoroquinolone antibiotics as potential drivers of fluoroquinolone resistance.

%B Journal of Antimicrobial Chemotherapy %V 75 %8 Dec-05-2020 %G eng %N 7 %R 10.1093/jac/dkaa128 %0 Journal Article %J Antimicrob Resist Infect Control %D 2020 %T Point prevalence survey of antimicrobial use and healthcare-associated infections in Belgian acute care hospitals: results of the Global-PPS and ECDC-PPS 2017. %A Eline Vandael %A Katrien Latour %A Goossens, Herman %A Koen Magerman %A Nico Drapier %A Boudewijn Catry %A Versporten, Ann %K point prevalence survey; healthcare-associated infections; antimicrobial use; acute care hospitals; Belgium %X

Background: The point prevalence survey of healthcare-associated infections (HAIs) and antimicrobial use organized by the European Centre for Disease Prevention and Control (ECDC-PPS) and the Global Point Prevalence Survey of antimicrobial consumption (Global-PPS) were simultaneously performed in Belgian acute care hospitals in 2017.

Methods: Belgian acute care hospitals were invited to participate in either the ECDC or Global-PPS. Hospital/ward/patient-level data were collected between September-December 2017. All patients present in the wards at 8 a.m. on the day of the PPS were included. The data of the ECDC and Global-PPS on antimicrobial consumption were pooled. Detailed data on HAIs were analysed for ECDC-PPS.

Results: Overall, 110 Belgian acute care hospital sites participated in the ECDC and Global-PPS (countrywide participation rate: 81.4%, 28,007 patients). Overall, a crude prevalence of patients with at least one antimicrobial of 27.1% (95% confidence interval (CI) 26.5-27.6%) was found. The most frequently reported indications were pneumonia (23.2%), urinary tract infections (15.2%) and skin and soft tissue infections (11.9%). The reason for antimicrobial use was recorded for 81.9% of the prescriptions, a stop/review date for 40.8% and compliance with local antibiotic guidelines for 76.6%. In the ECDC-PPS, the crude prevalence of patients with at least one HAI was 7.3% (95%CI 6.8-7.7%). Most frequently reported HAIs were pneumonia (21.6%) and urinary tract infections (21.3%).

Conclusions: HAI and antimicrobial use prevalence remained stable in comparison with the previous PPS (7.1% and 27.4% in 2011 and 2015, respectively). Belgian hospitals should be further stimulated to set local targets to improve antibiotic prescribing and reduce HAI.

%B Antimicrob Resist Infect Control %V 9 %8 2020 %G eng %R 10.1186/s13756-019-0663-7 %0 Report %D 2020 %T Protocol COVID-19 surveillance in residential institutions - version 4.2 %A Sara Dequeker %A Katrien Latour %A Esma Islamaj %A Laura Int Panis %A Milena Callies %A Lucy Catteau %A Boudewijn Catry %A Eline Vandael %V version 3.3 %P 19 %8 01/07/2020 %G eng %0 Report %D 2020 %T Resultaten van de 8e Nationale campagne ter bevordering van de handhygiëne in ziekenhuizen (2018-2019) %A H De Pauw %A Naima Benhammadi %A Nathalie Shodu %A Boudewijn Catry %G eng %0 Report %D 2020 %T Résultats de la 8ième campagne nationale de promotion de l'hygiène des mains dans les hôpitaux (2018-2019) %A H De Pauw %A N. Benhammadi %A Nathalie Shodu %A Boudewijn Catry %X

Hand hygiene (HH) compliance by healthcare professionals has been recognized as the most important factor in preventing transmission of healthcare-associated infections to patients. Countrywide campaigns have been consecutively organized in Belgian hospitals since 2005 and aim at raising awareness on good HH practices and promoting the use of alcohol based hand rubs. We report here the outcome of the eighth Belgian national hand hygiene campaign organized in 2018-2019.

 

Each biannual campaign focuses on a specific message taking into account specific findings of the last campaign. The 8th campaign was mainly focused on the importance of hand hygiene in the prevention of bloodstream infections, with the slogan “Hand hygiene, go for zero catheter related sepsis”. The main focus was on the prevention of vascular catheter-related bloodstream infections. This prevention covered both central venous catheter (CVC) and peripheral venous catheter infections. Compliance to hand hygiene guidelines was measured by the infection control teams of participating hospitals by direct observation using a standardized observation roster according to the World Health Organization (WHO). The timeline of the 8th campaign was organized as in previous campaigns: one month pre-campaign compliance measurement (from 05/11/2018 to 04/12/2018), one month of awareness campaign (from 04/02/2019 to 03/03/2019), and one month of post-campaign compliance measurement (from 01/04/2019 to 15/05/2019). The opportunities for hand hygiene were counted and the actual episodes of hand hygiene were scored as hand hygiene with alcohol-based hand rub, hand hygiene with water and soap, or no hand hygiene. Thus, the metric used was the number of episodes divided by the number of opportunities. An online tool (NSIHweb 2.0) was used to collect the individual or aggregated compliance data, with the possibility to obtain immediate feedback. For this eighth campaign, a new feature among the awareness-raising tools proposed was the creation of a “goose game” where patients, caregivers and/or any other participants can compete on the fundamentals of hand hygiene.

 

A total of a total of 235,026 hand hygiene opportunities were registered (116,167 before and 118,859 after campaign, respectively), retrieved from 152 participating hospitals (sites/mergers; 18 psychiatric hospitals, 12 chronic hospitals, 122 acute hospitals). At the national level, all specialties combined, the compliance (= hand hygiene opportunities with soap and/or alcohol / total number of hand hygiene opportunities observed) was 71.2% (P10: 52.2 ; P50: 73.4 ; P90: 86.8) before the campaign and 79.5% (P10: 68.6 ; P50: 80.6 ; P90: 89.9) after the campaign, representing a pre/post- difference of +8.3%. The Intensive Care Unit (ICU) showed a good score before (76%) and after (80%) campaign (n= 108 units observed) compared to the hospital as a whole. The indication “before venous/arterial contact”, the focus of the eighth campaign, was 76.2% before the campaign and 80% after the campaign. There was therefore an increase in compliance for this indication compared to the result of the seventh campaign (69.2% before and 76.2% after the campaign). As in the previous campaigns, nurses obtained the best results (74.7% before and 82.6% after the campaign).

 

The eighth national campaign was another success in terms of very high participation rates with a compliance rate that still tends to approach a 80% margin during post-campaign.

%G eng %0 Journal Article %J Euro Surveill %D 2019 %T Antibiotic consumption in Belgian acute care hospitals: analysis of the surveillance methodology, consumption evolution 2003 to 2016 and future perspectives. %A Eline Vandael %A Koen Magerman %A Coenen, Samuel %A Goossens, Herman %A Boudewijn Catry %K antibiotic consumption %K antimicrobial use %K Belgium %K hospitals %K Surveillance %X

Background: Studies have demonstrated the link between antimicrobial consumption and the development of antimicrobial resistance. Surveillance of antimicrobial consumption is an action point of the European Commission's 'One Health Action Plan Against Antimicrobial Resistance'.Aim: This study aims to compare two methodologies for antibiotic consumption surveillance, investigate the 14-year evolution of antibiotic consumption in Belgian acute care hospitals and discuss future perspectives.Methods: We compared self-reported data (old methodology) and reimbursement data (new methodology) of national antibiotic consumption surveillance in hospitals. Descriptive analyses were performed on the reimbursement data collected per year and per trimester (2003-2016), per hospital and per unit. Antibiotic consumption was compared with European Surveillance of Antimicrobial Consumption Network (ESAC-Net) results. Results: The median differences for defined daily doses (DDDs)/1,000 patient days and DDDs/1,000 admissions were 3.09% and 3.94% when comparing the old vs new methodology. Based on reimbursement data, the median antibiotic consumption in 2016 in 102 Belgian acute care hospitals was 577.1 DDDs/1,000 patient days and 3,890.3 DDDs/1,000 admissions with high variation between hospitals (interquartile ranges (IQR): 511.3-655.0 and 3,450.0-4,400.5, respectively), and similar to 2015. Based on DDDs/1,000 patient days, the magnitude of consumption is comparable with the Netherlands, Denmark and Sweden, but is higher when based on DDDs/1,000 admissions. Conclusion: Antibiotic consumption in Belgian acute care hospitals has remained overall stable over time. However, the high variation across hospitals should be further investigated. This surveillance data could be used for benchmarking and assessing interventions to improve antibiotic consumption in these hospitals.

%B Euro Surveill %V 24 %8 2019 Nov %G eng %N 46 %R 10.2807/1560-7917.ES.2019.24.46.1900098 %0 Journal Article %J Int Dent J %D 2019 %T Antimicrobial prescribing by Belgian dentists in ambulatory care, from 2010 to 2016. %A Thomas Struyf %A Eline Vandael %A Roos Leroy %A Karl Mertens %A Boudewijn Catry %K Ambulatory Care %K Anti-Bacterial Agents %K Anti-Infective Agents %K Belgium %K Dentists %K Humans %X

OBJECTIVES: To describe antimicrobial prescribing by Belgian dentists in ambulatory care, from 2010 until 2016.

MATERIALS AND METHODS: Reimbursement data from the Belgian National Institute for Health and Disability Insurance were analysed to evaluate antimicrobial prescribing (WHO ATC-codes J01/P01AB). Utilisation was expressed in defined daily doses (DDDs), and in DDDs and packages per 1000 inhabitants per day (DID and PID, respectively). Additionally, the number of DDD and packages per prescriber was calculated.

RESULTS: In 2016, the dentistry-related prescribing rate of 'Antibacterials for systemic use' (J01) and 'Antiprotozoals' (P01AB) was 1.607 and 0.014 DID, respectively. From 2010 to 2016, the DID rate of J01 increased by 6.3%, while the PID rate declined by 6.7%. Amoxicillin and amoxicillin with an enzyme inhibitor were the most often prescribed products, followed by clindamycin, clarithromycin, doxycycline, azithromycin and metronidazole. The proportion of amoxicillin relative to amoxicillin with an enzyme inhibitor was low. The narrow-spectrum antibiotic penicillin V was almost never prescribed.

CONCLUSIONS: Antibiotics typically classified as broad- or extended-spectrum were prescribed most often by Belgian dentists during the period 2000-2016. Although the DID rate of all 'Antibacterials for systemic use' (J01) increased over the years, the number of prescriptions per dentist decreased since 2013. The high prescription level of amoxicillin with an enzyme inhibitor is particularly worrying. It indicates that there is a need for comprehensive clinical practice guidelines for Belgian dentists.

%B Int Dent J %V 69 %8 2019 Dec %G eng %N 6 %R 10.1111/idj.12512 %0 Journal Article %J Lancet Infect Dis %D 2019 %T Attributable deaths and disability-adjusted life-years caused by infections with antibiotic-resistant bacteria in the EU and the European Economic Area in 2015: a population-level modelling analysis %A Alessandro Cassini %A Liselotte Diaz Högberg %A Diamantis Plachouras %A Annalisa Quattrocchi %A Ana Hoxha %A Gunnar Skov Simonsen %A Mélanie Colomb-Cotinat %A Mirjam E Kretzschmar %A Brecht Devleesschauwer %A Michele Cecchini %A Driss Ait Ouakrim %A Tiago Cravo Oliveira %A Marc J Struelens %A Carl Suetens %A Dominique L Monnet %? Katrien Latour %? Boudewijn Catry %? Karl Mertens %K Antimicrobial resistance %K burden of disease %K Disability-Adjusted Life Years %X

BACKGROUND: Infections due to antibiotic-resistant bacteria are threatening modern health care. However, estimating their incidence, complications, and attributable mortality is challenging. We aimed to estimate the burden of infections caused by antibiotic-resistant bacteria of public health concern in countries of the EU and European Economic Area (EEA) in 2015, measured in number of cases, attributable deaths, and disability-adjusted life-years (DALYs).

METHODS: We estimated the incidence of infections with 16 antibiotic resistance-bacterium combinations from European Antimicrobial Resistance Surveillance Network (EARS-Net) 2015 data that was country-corrected for population coverage. We multiplied the number of bloodstream infections (BSIs) by a conversion factor derived from the European Centre for Disease Prevention and Control point prevalence survey of health-care-associated infections in European acute care hospitals in 2011-12 to estimate the number of non-BSIs. We developed disease outcome models for five types of infection on the basis of systematic reviews of the literature.

FINDINGS: From EARS-Net data collected between Jan 1, 2015, and Dec 31, 2015, we estimated 671 689 (95% uncertainty interval [UI] 583 148-763 966) infections with antibiotic-resistant bacteria, of which 63·5% (426 277 of 671 689) were associated with health care. These infections accounted for an estimated 33 110 (28 480-38 430) attributable deaths and 874 541 (768 837-989 068) DALYs. The burden for the EU and EEA was highest in infants (aged <1 year) and people aged 65 years or older, had increased since 2007, and was highest in Italy and Greece.

INTERPRETATION: Our results present the health burden of five types of infection with antibiotic-resistant bacteria expressed, for the first time, in DALYs. The estimated burden of infections with antibiotic-resistant bacteria in the EU and EEA is substantial compared with that of other infectious diseases, and has increased since 2007. Our burden estimates provide useful information for public health decision-makers prioritising interventions for infectious diseases.

FUNDING: European Centre for Disease Prevention and Control.

%B Lancet Infect Dis %V 19 %8 2019 Jan %G eng %N 1 %R 10.1016/S1473-3099(18)30605-4 %0 Report %D 2019 %T Belgian Hospitals – Surveillance of Antimicrobial Consumption (BeH-SAC): 15-year evolution (2003-2017) of antimicrobial consumption in Belgian hospitals %A Eline Vandael %A Magerman,K. %A Boudewijn Catry %K antimicrobial consumption %K Belgian hospitals %K Surveillance %P 38 %8 15/03/2019 %G eng %U http://www.nsih.be/surv_gm/download_en.asp %0 Journal Article %J Epidemiol Infect %D 2019 %T The health and economic impact of acute gastroenteritis in Belgium, 2010-2014 %A Theofilos Papadopoulos %A Sofieke Klamer %A Stéphanie Jacquinet %A Boudewijn Catry %A Amber Litzroth %A Laure Mortgat %A Pavlos Mamouris %A Javiera Rebolledo %A Bert Vaes %A Dieter Van Cauteren %A Johan Van der Heyden %A Philippe Beutels %A Brecht Devleesschauwer %K burden of disease %K cost-of-illness %K Disability-Adjusted Life Years %K Gastroenteritis %X

Acute gastroenteritis (AGE) remains a common condition in both low- and high-income countries. In Belgium, however, there is currently a lack of information on the societal health and economic impact of AGE. We conducted a retrospective study using mortality and cause-of-death data, hospital data, primary care data, health interview survey data and other published data. We estimated the burden of illness during a 5-year period (2010-2014) in Belgium in terms of deaths, patients admitted to hospitals, patients consulting their general practitioner (GP) and cases occurring in the community. We further quantified the health impact in terms of disability-adjusted life years (DALYs) and the economic impact in terms of cost-of-illness estimates. We estimated 343 deaths, 27 707 hospitalised patients, 464 222 GP consultations and 10 058 741 episodes occurring in the community (0.91 cases/person) on average per year. AGE was associated with 11 855 DALYs per year (107 DALY per 100 000 persons). The economic burden was estimated to represent direct costs of €112 million, indirect costs of €927 million (90% of the total costs) and an average total cost of €103 per case and €94 per person. AGE results in a substantial health and economic impact in Belgium, justifying continued mitigation efforts.

%B Epidemiol Infect %V 147 %8 2019 Jan %G eng %R 10.1017/S095026881900044X %0 Journal Article %J PLOS ONE %D 2019 %T Prevalence of multidrug-resistant organisms in nursing homes in Belgium in 2015 %A Katrien Latour %A Huang, Te-Din %A Beatrice Jans %A Berhin, Catherine %A Bogaerts, Pierre %A Audrey Noel %A Nonhoff, Claire %A Magali Dodémont %A Denis, Olivier %A Margareta Ieven %A Katherine Loens %A Schoevaerdts, Didier %A Boudewijn Catry %A Glupczynski, Youri %B PLOS ONE %V 14 %8 Apr-03-2021 %G eng %N 3 %R 10.1371/journal.pone.021432710.1371/journal.pone.0214327.g00110.1371/journal.pone.0214327.t00110.1371/journal.pone.0214327.t00210.1371/journal.pone.0214327.t00310.1371/journal.pone.0214327.t00410.1371/journal.pone.0214327.t005 %0 Generic %D 2019 %T Results of the Global and ECDC Point Prevalence Surveys of Antimicrobial Use and Healthcare-Associated Infections in Belgian Acute Care Hospitals in 2017 %A Eline Vandael %A Katrien Latour %A Goossens,H. %A Magerman,K. %A Boudewijn Catry %A Versporten, Ann %K antimicrobial use %K healthcare associated infections %K point-prevalence %B ECCMID %C Amsterdam %G eng %0 Journal Article %J Mycoses %D 2019 %T Systemic antifungal drug use in Belgium-One of the biggest antifungal consumers in Europe. %A Berdieke Goemaere %A Lagrou, Katrien %A Spriet, Isabel %A Marijke Hendrickx %A Eline Vandael %A Pierre Becker %A Boudewijn Catry %K Antifungal Agents %K Belgium %K Drug Utilization %K Female %K Humans %K intensive care units %K Male %K Mycoses %X

BACKGROUND: Reports on the consumption of systemic antifungal drugs on a national level are scarce although of high interest to compare trends and the associated epidemiology in other countries and to assess the need for antifungal stewardship programmes.

OBJECTIVES: To estimate patterns of Belgian inpatient and outpatient antifungal use and provide reference data for other countries.

METHODS: Consumption records of antifungals were collected in Belgian hospitals between 2003 and 2016. Primary healthcare data were available for the azoles for the period 2010-2016.

RESULTS: The majority of the antifungal consumption resulted from prescriptions of fluconazole and itraconazole in the ambulatory care while hospitals were responsible for only 6.4% of the total national consumption and echinocandin use was limited. The annual average antifungal consumption in hospitals decreased significantly by nearly 25% between 2003 and 2016, due to a decrease solely in non-university hospitals. With the exception of specialised burn centres, antifungals are mostly consumed at ICUs and internal medicine wards. A significant decline was also observed in the consumption of azoles in primary health care, attributed to itraconazole. The major part of azoles was prescribed by generalists followed by dermatologists.

CONCLUSIONS: In spite of the downward trend in annual use of systemic antifungal drugs, Belgium remains one of the biggest consumers in Europe.

%B Mycoses %V 62 %8 2019 Jun %G eng %N 6 %R 10.1111/myc.12912 %0 Journal Article %J Journal of Antimicrobial Chemotherapy %D 2019 %T Time trend of prevalence and susceptibility to nitrofurantoin of urinary MDR Escherichia coli from outpatients %A Bruyndonckx, Robin %A Katrien Latour %A Atud, Glory Abong %A Patrick Dubovy %A Jaspers, Stijn %A Hens, Niel %A Boudewijn Catry %A Goossens, Herman %A Coenen, Samuel %K Antimicrobial resistance %K Nitrofurantoin %K urine specimens %X

Objectives: To assess the time trend of the prevalence of urinary MDR Escherichia coli in Belgian outpatients (2005 versus 2011-12), the antibiotic susceptibility of urinary MDR E. coli, and the time trend of non-susceptibility to nitrofurantoin, i.e. first-line treatment for uncomplicated urinary tract infections (UTIs), of urinary MDR E. coli (2005 versus 2011-12).

Methods: In this secondary analysis of a multicentre study, which collected a convenience sample of voluntary participating laboratories (15 and 8 in 2005 and 2011-12, respectively), we analysed antimicrobial susceptibilities (ampicillin, amoxicillin/clavulanate, cefalotin, ciprofloxacin, nitrofurantoin and trimethoprim/sulfamethoxazole) of urinary E. coli. MDR was defined as resistance to three or more of these agents. The prevalence of MDR E. coli and its non-susceptibility to nitrofurantoin was compared between 2005 and 2011-12 using a generalized estimating equation model.

Results: MDR status could be determined for 9704 and 12512 urinary E. coli isolates from 7911 and 9441 patients in 2005 and 2011-12, respectively, with most patients being women (79% in both study periods). The prevalence of MDR increased from 28.4% (2758/9704) in 2005 to 34.3% (4286/12512) in 2011-12 (adjusted OR 1.305; 95% CI 1.220-1.397). Within the MDR isolates, the prevalence of nitrofurantoin non-susceptibility decreased from 23.2% (623/2684) in 2005 to 10.7% (455/4253) in 2011-12 (adjusted OR 0.424; 95% CI 0.363-0.494).

Conclusions: Despite a high prevalence of MDR E. coli in urinary samples from Belgian outpatients, nitrofurantoin could still be recommended as first-line empirical treatment in uncomplicated UTIs.

%B Journal of Antimicrobial Chemotherapy %V 74 %8 Mar-08-2019 %G eng %N 11 %R 10.1093/jac/dkz323 %0 Government Document %D 2018 %T Antimicrobiële consumptie in de ambulante praktijk en ziekenhuizen in België: resultaten van de ESAC-Net en BeH-SAC surveillances %A Eline Vandael %A Boudewijn Catry %B Noso-Info %V XXII %P 3 %G eng %N 4 %R http://www.nosoinfo.be/nosoinfos/antimicrobiele-consumptie-in-de-ambulante-praktijk-en-ziekenhuizen-in-belgie-resultaten-van-de-esac-net-en-beh-sac-surveillances/?lang=nl&ref=r418 %0 Journal Article %J Journal of Epidemiology and Public Health Reviews %D 2018 %T Care Infections & Antibiotic Resistance in Belgium %A Boudewijn Catry %A Karl Mertens %A Katrien Latour %A B, Legiest %A Els Duysburgh %A T, Papadopoulos %A E, Vandael %A T, Struyf %A Laure Mortgat %A N, Benhammadi %A H De Pauw %A Herman Van Oyen %K antimicrobial consumption %K Blood stream infection %K Clostridium difficile %K CPE %K ESBL %K Hand hygiene %K healthcare associated infections %K ICU %K MRSA %K VRE %X

This activity report provides an overview of the most recent evolutions in healthcare associated infections and antimicrobial resistance in Belgium. The positive downward trend we have been observing for many years in the incidence of Methicillin Resistant Staphylococcus aureus (MRSA) in acute care hospitals appears to be stabilizing in 2016. The hand hygiene campaigns held biannually since 2005, which reduce -among many other initiatives- the spread of these bacteria through direct contact, contribute to this evolution. Also in intensive care units hand hygiene compliance increased significantly and the incidence of pneumonia following intubation has reduced remarkably.
Other resistant bacteria, mainly present as a reservoir in the digestive tract (gut), are however on the rise and can cause severe bloodstream infections. In particular, Carbapenemase-Producing Enterobacteriaceae (CPE) and Vancomycin-Resistant Enterococci (VRE) are increasingly being isolated and have caused outbreaks in several hospitals. The number of Clostridium difficile infections (severe enteritis and colitis) also slightly increased since 2014, although its associated mortality decreased. In long-term care facilities (among others nursing homes), similar evolutions are taking place (decrease in MRSA, increase in multi-resistant gut bacteria). Long term monitoring shows a recent slight decrease in antimicrobial consumption in the ambulant sector but alas not in the hospitals. Antimicrobial use should urgently be further optimized in our healthcare facilities in order to control the selection pressure for antimicrobial resistance.
Since 2014 and in collaboration with the inspection services of the competent authorities, assistance is being offered to hospitals and long-term care facilities that suffer from difficult to treat bacteria in the form of an outbreak support team (MDRO – OST; Multi-Drug Resistant Organisms - Outbreak Support Team). In the period 2014-2016, 13 out of 15 reported outbreaks where assistance was granted, containment was achieved within a reasonable time frame.

%B Journal of Epidemiology and Public Health Reviews %V 3 %8 Jan-01-2018 %G eng %N 2 %& 1 %R 10.16966/2471-8211.165 %0 Journal Article %J Antimicrobial Resistance & Infection Control %D 2018 %T Characteristics of the antibiotic regimen that affect antimicrobial resistance in urinary pathogens %A Boudewijn Catry %A Katrien Latour %A Bruyndonckx, Robin %A Camellia Diba %A Candida Geerdens %A Coenen, Samuel %K Drug Resistance %K ELDERLY %K Route of administration %K Uropathogens %X

Background

Treatment duration, treatment interval, formulation and type of antimicrobial (antibiotic) are modifiable factors that will influence antimicrobial selection pressure. Currently, the impact of the route of administration on the occurrence of resistance in humans is unclear.

Methods

In this retrospective multi-center cohort study, we assessed the impact of different variables on antimicrobial resistance (AMR) in pathogens isolated from the urinary tract in older adults. A generalized estimating equations (GEE) model was constructed using 7397 Escherichia coli (E. coli) isolates.

Results

Resistance in E. coli was higher when more antibiotics had been prescribed before isolation of the sample, especially in women (significant interaction p = 0.0016) and up to nine preceding prescriptions it was lower for higher proportions of preceding parenteral prescriptions (significant interactions p = 0.0067). The laboratory identity, dying, and the time between prescription and sampling were important confounders (p < 0.001).

Conclusions

Our model describing shows a dose-response relation between antibiotic use and AMR in E. coli isolated from urine samples of older adults, and, for the first time, that higher proportions of preceding parenteral prescriptions are significantly associated with lower probabilities of AMR, provided that the number of preceding prescriptions is not extremely high (≥10 during the 1.5 year observation period; 93% of 5650 included patients).

%B Antimicrobial Resistance & Infection Control %V 7 %8 Jan-12-2018 %G eng %N 1 %R 10.1186/s13756-018-0368-3 %0 Government Document %D 2018 %T Consommation d’antimicrobiens dans la pratique ambulatoire et les hôpitaux en Belgique : résultat des surveillances ESAC-Net et BeH-SAC %A Eline Vandael %A Boudewijn Catry %B Noso-Info %V XXII %P 3 %G eng %N 4 %R http://www.nosoinfo.be/nosoinfos/consommation-dantimicrobiens-dans-la-pratique-ambulatoire-et-les-hopitaux-en-belgique-resultat-des-surveillances-esac-net-et-beh-sac/?ref=r418 %0 Report %D 2018 %T De stem van de patiënt: "Een analyse van de ervaringen van patiënten met de 7e nationale campagne ter bevordering van handhygiëne" (2018) %A H De Pauw %A A. Uwineza %A N. Benhammadi %A Boudewijn Catry %E A. Simon %E L. Popleu %E A. Willemse %E F. De Meerleer %E A. Spettante %E P. Taminiau %E A. Metango %E F. Antoine %K Enquête %K Patient %K stem %I Sciensano %C Bruxelles, Belgique %P 22 %8 2018 %G eng %M D/2018/14.470.7 %0 Report %D 2018 %T La voix du patient: "Une analyse sur l'expérience des patients vis-à-vis de la 7ème campagne nationale de promotion de l'hygiène des mains (2016-2017) %A H De Pauw %A A. Uwineza %A N. Benhammadi %A Boudewijn Catry %E A. Simon %Y L. Popleu %? A. Willemse %? F. De Meerleer %? A. Spettante %? P. Taminiau %? A. Metango %? F. Antoine %G eng %0 Report %D 2018 %T Point Prevalence Study of Healthcare-Associated Infections and Antimicrobial Use in Belgian Acute-Care Hospitals: Results of the ECDC PPS 2017 %A Eline Vandael %A Boudewijn Catry %A Katrien Latour %K point prevalence survey; healthcare-associated infections; antimicrobial use; acute care hospitals; Belgium %X

Background:

In 2011, the first European point prevalence study (PPS) of antimicrobial use and healthcare-associated infections (HAIs) was organised by the European Centre for Disease Prevention and Control (ECDC). In the participating Belgian acute care hospital sites (N=52, September-December 2011), the prevalence of patients with at least one antimicrobial and at least one HAI was 28.9% (95% confidence interval (CI): 26.8-31.1%) and 7.1% (95% CI: 6.1-8.3%), respectively. The objective of this report is to present the results of the second ECDC PPS conducted in 2017 in Belgian acute care hospitals.

Methods:

All Belgian acute care hospitals were invited to participate in the ECDC PPS 2017. In addition, a representative random sample of hospitals was selected which received an individualized invitation to participate. Training was provided to the participating hospitals in September 2017, followed by the data collection between September and November 2017. Data were collected at hospital, ward and patient levels. All patients who were present on the ward at 8h00 a.m. on the day of the PPS and who were not discharged at the time of the survey had to be included. Data collection had to be performed on one single day per ward, within a maximum period of 2 to 3 weeks for each hospital.

Results:

In total, 47 acute care hospital sites (33 mergers, of which 22 primary, 9 secondary and 2 tertiary hospitals, countrywide participation 32.4%) participated in the ECDC PPS (11800 patients included, mean age 60.2±25.3 year, 55.2% females). The crude prevalence of patients with at least one antimicrobial agent was 28.1% (95% CI: 27.3-29.0%). Medical prophylaxis, surgical prophylaxis and treatment of HAIs were reported as indication in 6.2%, 13.5% and 24.2% of the prescribed antimicrobial agents (N=4103), respectively. The top 3 of most used antimicrobial agents consisted of amoxicillin in combination with a beta-lactamase inhibitor (J01CR02, 19.7%), cefazolin (J01DB04, 9.7%) and piperacillin in combination with a beta-lactamase inhibitor (J01CR05, 7.7%). The most frequently reported diagnoses for medical antimicrobial treatment were pneumonia (22.2%) and urinary tract infections (11.2%). The reason for antimicrobial use was available in 80.8% of the medical notes.

A crude prevalence of patients with at least one HAI of 7.3% (95% CI: 6.8-7.7%) was detected. The most frequently reported HAIs (N=911) were pneumonia (21.6%), urinary tract infections (21.3%) and surgical site infections (16.9%). Microbiological results were available for 62.0% of the HAIs. A total of 721 microorganisms were reported. The most commonly isolated microorganism was Escherichia coli (17.8%).

Conclusions:

In comparison with the Belgian results of the ECDC PPS in 2011, the prevalence of antimicrobial consumption and the prevalence of HAI remained the same. The reasons for the high prevalence of HAIs should be further investigated and targets should be set to improve. It is recommended that hospitals participate regulary in a PPS.

%I Sciensano %C Brussels, Belgium %P 34 %8 11/2018 %G eng %U http://www.nsih.be/ecdcpps/download_nl.asp %M D/2018/14.440/37 %0 Journal Article %J Eurosurveillance %D 2018 %T Prevalence of healthcare-associated infections, estimated incidence and composite antimicrobial resistance index in acute care hospitals and long-term care facilities: results from two European point prevalence surveys, 2016 to 2017 %A Suetens, Carl %A Katrien Latour %A Tommi Kärki %A Enrico Ricchizzi %A Pete Kinross %A Maria Luisa Moro %A Beatrice Jans %A Susan Hopkins %A Sonja Hansen %A Lyytikäinen, Outi %A Jacqui Reilly %A Aleksander Deptula %A Walter Zingg %A Plachouras, Diamantis %A Dominique L Monnet %A Eline Vandael %A Boudewijn Catry %K Acute care hospitals %K Antimicrobial resistance %K antimicrobial use %K Healthcare-associated infection %K long-term care facilities %X

Point prevalence surveys of healthcare-associated infections (HAI) and antimicrobial use in the European Union and European Economic Area (EU/EEA) from 2016 to 2017 included 310,755 patients from 1,209 acute care hospitals (ACH) in 28 countries and 117,138 residents from 2,221 long-term care facilities (LTCF) in 23 countries. After national validation, we estimated that 6.5% (cumulative 95% confidence interval (cCI): 5.4–7.8%) patients in ACH and 3.9% (95% cCI: 2.4–6.0%) residents in LTCF had at least one HAI (country-weighted prevalence). On any given day, 98,166 patients (95% cCI: 81,022–117,484) in ACH and 129,940 (95% cCI: 79,570–197,625) residents in LTCF had an HAI. HAI episodes per year were estimated at 8.9 million (95% cCI: 4.6–15.6 million), including 4.5 million (95% cCI: 2.6–7.6 million) in ACH and 4.4 million (95% cCI: 2.0–8.0 million) in LTCF; 3.8 million (95% cCI: 3.1–4.5 million) patients acquired an HAI each year in ACH. Antimicrobial resistance (AMR) to selected AMR markers was 31.6% in ACH and 28.0% in LTCF. Our study confirmed a high annual number of HAI in healthcare facilities in the EU/EEA and indicated that AMR in HAI in LTCF may have reached the same level as in ACH.

%B Eurosurveillance %V 23 %8 Mar-11-2019 %G eng %N 46 %R 10.2807/1560-7917.ES.2018.23.46.1800516 %0 Report %D 2018 %T Result of the 7th national campaign of hand hygiene %A H De Pauw %A A. Uwineza %A N. Benhammadi %A Boudewijn Catry %G eng %0 Government Document %D 2018 %T Resultaten van de tweede ECDC puntprevalentiestudie van antimicrobiële consumptie en zorginfecties in Belgische acute ziekenhuizen in 2017 %A Eline Vandael %A Boudewijn Catry %A Katrien Latour %K Acute care hospitals %K Antimicrobial resistance %K antimicrobial use %K Healthcare-associated infection %X

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%B Noso-Info %I Noso-Info %C Brussels, Belgium %V XXII %P 3 %8 2018 %G eng %N 4 %& 10 %0 Report %D 2018 %T Résultats de la 7ème campagne nationale pour la promotion de l'hygiène des mains dans les hôpitaux (2016-2017) %A H De Pauw %A A. Uwineza %A N. Benhammadi %A Boudewijn Catry %G eng %0 Government Document %D 2018 %T Résultats de la deuxième étude de prévalence sur la consommation d’antimicrobiens et les infections de soins dans les hôpitaux belges aigus en 2017 %A Eline Vandael %A Boudewijn Catry %A Katrien Latour %K Acute care hospital %K Antimicrobial resistance %K antimicrobial use %K Healthcare-associated infection %X

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%B Noso-Info %I Noso-Info %C Brussels, Belgium %V XXII %P 3 %8 2018 %G eng %N 4 %& 10 %0 Generic %D 2018 %T Surveillance of antimicrobial consumption in Belgian hospitals (BeH-SAC): a reviewed methodology %A Eline Vandael %A Magerman,K. %A Boudewijn Catry %K antimicrobial consumption %K Belgium %K hospital %B ECCMID conference %C Madrid, Spain %G eng %U http://m.eccmidlive.org/#Home %0 Government Document %D 2017 %T Antibioticaresistentie: Een ernstige bedreiging voor de gezondheidszorg %A Eline Vandael %A Boudewijn Catry %K Antimicrobial resistance %B Farmazine %V 75 %G eng %0 Report %D 2017 %T Nationale Surveillance van Nosocomiale Infecties in Intensieve Zorgen, Protocol HELICS België (inc addendum) %A Karl Mertens %A C. Suetens %A Morales,I. %A Boudewijn Catry %K Antimicrobial resistance %K Bloodstream infection %K european center for disease control %K Healthcare-associated infection %K icu-acquired infection %K intensive care unit %K nosocomial infection %K Pneumonia %I Scientific institute of public health %C Brussels, Belgium %P 55 %8 March 2017 %G eng %M n/a %0 Journal Article %J Transbound Emerg Dis %D 2017 %T Nosocomial Intravascular Catheter Infections with Extended-spectrum Beta-lactamase-producing Escherichia coli in Calves after Strain Introduction from a Commercial Herd. %A Pardon, B %A Smet, A %A Butaye, P %A Argudín, M A %A Valgaeren, B %A Boudewijn Catry %A Haesebrouck, F %A Deprez, P %K Animals %K Bacterial Proteins %K beta-Lactamases %K Catheters %K Cattle %K Cattle Diseases %K Cross Infection %K Electrophoresis, Gel, Pulsed-Field %K Escherichia coli %K Escherichia coli Infections %K Hospitals, Animal %K Hospitals, Teaching %X

An outbreak of intravascular catheter-related infections by extended-spectrum β-lactamase (ESBL)-producing Escherichia coli in calves in an animal teaching hospital is reported. Pulsed-field gel electrophoresis was used for strain typing to determine the origin and dissemination of these strains. All 19 strains harboured the blaCTX-M-14, and six strains also overexpressed their chromosomal AmpC gene. Evidence on the introduction of the strain from a beef herd, experiencing neonatal diarrhoea and increased mortality, to the clinic through admission of diarrhoeic calves was provided. Strains isolated from phlebitis cases from other herds up to 5 months later showed a high similarity with the initial strain, suggesting that the strain had become nosocomial. The catheter infections with ESBL/AmpC-producing E. coli resulted in a prolonged hospitalization, increased anti-microbial use and mortality. This report points towards the potential dangers of the emergence of ESBL/AmpC-producing bacteria in susceptible food animals and warns farmers and veterinarians for the facility by which they are introduced into another environment.

%B Transbound Emerg Dis %V 64 %P 130-136 %8 2017 Feb %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/25903854?dopt=Abstract %R 10.1111/tbed.12352 %0 Journal Article %J J Glob Antimicrob Resist %D 2017 %T Persistence of antimicrobial resistance in respiratory streptococci. %A Bruyndonckx, Robin %A Hens, Niel %A Aerts, Marc %A Goossens, Herman %A Katrien Latour %A Boudewijn Catry %A Coenen, Samuel %X

OBJECTIVES: To assess whether persistence of antimicrobial resistance (i.e. non-susceptible resistance status) after treatment with penicillins or cephalosporins versus macrolides or tetracyclines differs and to compare the results obtained using routinely collected data with findings reported in prospective studies.

METHODS: Routinely collected microbiological data from 14 voluntary participating laboratories (2005) containing information on resistance status and individual antimicrobial consumption patterns (mid 2004-2005) were analysed using a generalised estimating equation (GEE) approach. The link function was adjusted to acknowledge that the proportion of resistant isolates in the population not treated with antibiotics [baseline resistance (BR)] is not necessarily zero. To optimise the comparability of this study with prospective studies, the analysis was repeated after removal of 14 isolates from patients who did not survive 2005.

RESULTS: BR estimates were unstable and their confidence intervals were wide, which called for a sensitivity analysis using an adjusted GEE model with three different BR estimates. All models indicated that the proportion of susceptible isolates differed by treatment group and increased significantly over time, with this increase being independent of treatment group. Persistence of resistance after exposure to macrolides or tetracyclines was approximately three times as long as after exposure to penicillins or cephalosporins.

CONCLUSIONS: Resistance following treatment with macrolides or tetracyclines persists longer than following treatment with penicillins or cephalosporins, which confirms the findings from prospective studies and suggests the use of routinely collected data as a valuable alternative to determine such differences in persistence of resistance.

%B J Glob Antimicrob Resist %V 8 %P 6-12 %8 2017 Mar %G eng %1 http://www.ncbi.nlm.nih.gov/pubmed/27865986?dopt=Abstract %R 10.1016/j.jgar.2016.09.009 %0 Report %D 2017 %T Protocole d’étude Surveillance des Infections Nosocomiales aux Soins Intensifs, Protocole HELICS Belgique (inc addendum) %A Karl Mertens %A Suetens, C %A Morales,I. %A Boudewijn Catry %K Antimicrobial resistance %K Bloodstream infection %K european center for disease control %K Healthcare-associated infection %K icu-acquired infection %K intensive care unit %K nosocomial infection %K Pneumonia %I Scientific institute of public health %C Brussels, Belgium %P 54 %8 March 2017 %G eng %M n/a %0 Journal Article %J J Antimicrob Chemother %D 2017 %T Public health risk of antimicrobial resistance transfer from companion animals. %A Pomba, Constança %A Rantala, Merja %A Greko, Christina %A Baptiste, Keith Edward %A Boudewijn Catry %A van Duijkeren, Engeline %A Mateus, Ana %A Moreno, Miguel A %A Pyörälä, Satu %A Ruzauskas, Modestas %A Sanders, Pascal %A Teale, Christopher %A Threlfall, E John %A Kunsagi, Zoltan %A Torren-Edo, Jordi %A Jukes, Helen %A Törneke, Karolina %K Animals %K bacteria %K Bacterial Infections %K Disease Transmission, Infectious %K Drug Resistance, Bacterial %K Humans %K Pets %K Risk Assessment %K Zoonoses %X

Antimicrobials are important tools for the therapy of infectious bacterial diseases in companion animals. Loss of efficacy of antimicrobial substances can seriously compromise animal health and welfare. A need for the development of new antimicrobials for the therapy of multiresistant infections, particularly those caused by Gram-negative bacteria, has been acknowledged in human medicine and a future corresponding need in veterinary medicine is expected. A unique aspect related to antimicrobial resistance and risk of resistance transfer in companion animals is their close contact with humans. This creates opportunities for interspecies transmission of resistant bacteria. Yet, the current knowledge of this field is limited and no risk assessment is performed when approving new veterinary antimicrobials. The objective of this review is to summarize the current knowledge on the use and indications for antimicrobials in companion animals, drug-resistant bacteria of concern among companion animals, risk factors for colonization of companion animals with resistant bacteria and transmission of antimicrobial resistance (bacteria and/or resistance determinants) between animals and humans. The major antimicrobial resistance microbiological hazards originating from companion animals that directly or indirectly may cause adverse health effects in humans are MRSA, methicillin-resistant Staphylococcus pseudintermedius, VRE, ESBL- or carbapenemase-producing Enterobacteriaceae and Gram-negative bacteria. In the face of the previously recognized microbiological hazards, a risk assessment tool could be applied in applications for marketing authorization for medicinal products for companion animals. This would allow the approval of new veterinary medicinal antimicrobials for which risk levels are estimated as acceptable for public health.

%B J Antimicrob Chemother %V 72 %P 957-968 %8 2017 Apr 01 %G eng %N 4 %1 http://www.ncbi.nlm.nih.gov/pubmed/27999066?dopt=Abstract %R 10.1093/jac/dkw481 %0 Journal Article %J Epidemiology %D 2016 %T Ambient Air Pollution-related Mortality in Dairy Cattle: Does It Corroborate Human Findings? %A Cox, Bianca %A Gasparrini, Antonio %A Boudewijn Catry %A Fierens, Frans %A Vangronsveld, Jaco %A Nawrot, Tim S %X

BACKGROUND: Despite insights for humans, short-term associations of air pollution with mortality to our knowledge have never been studied in animals. We investigated the association between ambient air pollution and risk of mortality in dairy cows and assessed effect modification by season.

METHODS: We collected ozone (O3), particulate matter (PM10), and nitrogen dioxide (NO2) concentrations at the municipality level for 87,108 dairy cow deaths in Belgium from 2006 to 2009. We combined a case-crossover design with time-varying distributed lag models.

RESULTS: We found acute and delayed associations between air pollution and dairy cattle mortality during the warm season. The increase in mortality for a 10 μg/m increase in 2-day (lag 0-1) O3 was 1.2% (95% confidence interval [CI] = 0.3%, 2.1%), and the corresponding estimates for a 10 μg/m increase in same-day (lag 0) PM10 and NO2 were 1.6% (95% CI = 0.0%, 3.1%) and 9.2% (95% CI = 6.3%, 12%), respectively. Compared with the acute increases, the cumulative 26-day (lag 0-25) estimates were considerably larger for O3 (3.0%; 95% CI = 0.2%, 6.0%) and PM10 (3.2%; 95% CI = -0.6%, 7.2%), but not for NO2 (1.4%; 95% CI = -4.9%, 8.2%). In the cold season, we only observed increased mortality risks associated with same-day (lag 0) exposure to NO2 (1.4%; 95% CI = -0.1%, 3.1%) and with 26-day (lag 0-25) exposure to O3 (4.6%; 95% CI = 2.2%, 7.0%).

CONCLUSIONS: Our study adds to the epidemiologic findings in humans and reinforces the evidence on the plausibility of causal effects. Furthermore, our results indicate that air pollution associations go beyond short-term mortality displacement. (See video abstract at http://links.lww.com/EDE/B105.).

%B Epidemiology %V 27 %P 779-86 %8 2016 Nov %G eng %N 6 %1 http://www.ncbi.nlm.nih.gov/pubmed/27468004?dopt=Abstract %R 10.1097/EDE.0000000000000545 %0 Journal Article %J Vet Microbiol %D 2016 %T Antimicrobial resistance surveillance in Escherichia coli by using normalized resistance interpretation. %A Bénédicte Callens %A Dewulf, Jeroen %A Kronvall, Göran %A Boudewijn Catry %A Haesebrouck, Freddy %A Boyen, Filip %K Animals %K Anti-Bacterial Agents %K Drug Resistance, Bacterial %K Escherichia coli %K Escherichia coli Infections %K Microbial Sensitivity Tests %K Swine %K Swine Diseases %X

OBJECTIVES: To improve antimicrobial surveillance accuracy for results obtained by disk diffusion for porcine Escherichia coli, by comparing traditional clinical breakpoint interpretation with the Normalized Resistance Interpretation (NRI) method.

METHODS: The susceptibilities of 921 E. coli isolates from clinically healthy pigs at slaughter age was determined for 15 antimicrobials by the Kirby Bauer disk diffusion technique. NRI with previously established optimal controlled parameters for E. coli ATCC25922 was used to reconstruct the fully susceptible population of the tested E. coli isolates. Based on a lower limit for susceptibility, set at 2.5 standard deviations below the mean of the reconstructed susceptible population, the non-wild type percentage isolates was compared with the clinical resistance percentage.

RESULTS: The NRI method was applicable for 11 out of the 15 antimicrobials tested. Antimicrobials for which no normal distribution of inhibition zones for the population of susceptible isolates was seen, could not be used to reconstruct the susceptible population. Clinical breakpoints much lower than the epidemiological cut-off values resulted into presumptively identifying isolates as clinically susceptible, but likely carrying acquired resistance determinants. Otherwise, clinical breakpoints did cut through the WT population for several antibiotics tested, categorizing isolates from the WT population as not susceptible.

CONCLUSIONS: NRI was shown to be a valid method to define the WT population for disk diffusion outcomes, provided a normal distribution of the susceptible bacterial species population is present. Until international harmonization of breakpoints is achieved, it might give rise to a wide application in monitoring antimicrobial resistance in veterinary medicine.

%B Vet Microbiol %V 197 %P 1-7 %8 2016 Dec 25 %G eng %1 http://www.ncbi.nlm.nih.gov/pubmed/27938670?dopt=Abstract %R 10.1016/j.vetmic.2016.10.019 %0 Journal Article %J Arch Public Health %D 2016 %T Belgian hand hygiene campaigns in ICU, 2005-2015. %A Sylvanus Fonguh %A Annie Uwineza %A Boudewijn Catry %A Simon, Anne %X

BACKGROUND: Healthcare-associated infections (HCAI) are still a major problem especially in most intensive care units (ICU). Incompliance by clinical staff with hand hygiene (HH) increases rates of preventable infections. We report the outcome of the Belgian national hand hygiene campaign from 2005 to 2015 with focus on intensive care units.

METHODS: Using the World Health organisation (WHO) standardised observation roster, trained infection control teams measured adherence to HH guidelines by direct observation. HH opportunities were counted and the actual episodes of HH were scored as no HH, HH with water and soap, or HH with alcohol-based hand rub. Measurements were repeatedly done before and after a one month awareness campaign every second year. Compliance was stratified by indication and by type of healthcare worker, and computed as a percentage of the number of HH episodes with water and soap or with alcohol-based hand rub, divided by the number of opportunities.

RESULTS: A total of 108,050 hand hygiene opportunities were observed in ICU during this period. HH compliance increased significantly from 49.6 % before campaign in 2005 to 72.0 % before campaign in 2015. Over the same time frame, post campaign compliance increased from 67.0 to 80.2 %. The number of opportunities observed substantially increased when automated feedback was installed.

CONCLUSIONS: In Belgian intensive care units, hand hygiene compliance is getting improved overtime, though consecutive campaigns with immediate feedback are required to achieve and sustain a high compliance rate.

%B Arch Public Health %V 74 %P 47 %8 2016 %G eng %1 http://www.ncbi.nlm.nih.gov/pubmed/27826443?dopt=Abstract %R 10.1186/s13690-016-0159-3 %0 Journal Article %J PLoS One %D 2016 %T Effect of Antimicrobial Consumption and Production Type on Antibacterial Resistance in the Bovine Respiratory and Digestive Tract. %A Boudewijn Catry %A Dewulf, Jeroen %A Maes, Dominiek %A Pardon, Bart %A Bénédicte Callens %A Vanrobaeys, Mia %A Opsomer, Geert %A de Kruif, Aart %A Haesebrouck, Freddy %K Agriculture %K Animals %K Anti-Bacterial Agents %K beta-Lactams %K Cattle %K Cattle Diseases %K Cephalosporins %K Drug Resistance, Bacterial %K Drug Utilization %K Escherichia coli %K Microbial Sensitivity Tests %K prevalence %K Prospective Studies %K Respiratory Tract Infections %X

The aim of this study was to investigate the relationship between antimicrobial use and the occurrence of antimicrobial resistance in the digestive and respiratory tract in three different production systems of food producing animals. A longitudinal study was set up in 25 Belgian bovine herds (10 dairy, 10 beef, and 5 veal herds) for a 2 year monitoring of antimicrobial susceptibilities in E. coli and Pasteurellaceae retrieved from the rectum and the nasal cavity, respectively. During the first year of observation, the antimicrobial use was prospectively recorded on 15 of these farms (5 of each production type) and transformed into the treatment incidences according to the (animal) defined daily dose (TIADD) and (actually) used daily dose (TIUDD). Antimicrobial resistance rates of 4,174 E. coli (all herds) and 474 Pasteurellaceae (beef and veal herds only) isolates for 12 antimicrobial agents demonstrated large differences between intensively reared veal calves (abundant and inconstant) and more extensively reared dairy and beef cattle (sparse and relatively stable). Using linear mixed effect models, a strong relation was found between antimicrobial treatment incidences and resistance profiles of 1,639 E. coli strains (p<0.0001) and 309 Pasteurellaceae (p≤0.012). These results indicate that a high antimicrobial selection pressure, here found to be represented by low dosages of oral prophylactic and therapeutic group medication, converts not only the commensal microbiota from the digestive tract but also the opportunistic pathogenic bacteria in the respiratory tract into reservoirs of multi-resistance.

%B PLoS One %V 11 %P e0146488 %8 2016 %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/26820134?dopt=Abstract %R 10.1371/journal.pone.0146488 %0 Report %D 2016 %T Etude nationale de prévalence du portage de germes résistants aux antibiotiques en maison de repos et de soins (MRS) en Belgique en 2015: Rapport final - juillet 2016 %A Beatrice Jans %A Katrien Latour %A Boudewijn Catry %A Argudin, M. %A Deplano,A. %A Dodémont, M %A Nonhoff,C. %A Roisin, S %A Denis, O %A Loens,K. %A Ieven, M %A Goossens,H. %A Huang, T.D. %A Berhin,C. %A Bogaerts, P %A Schoevaerdts, D %A Glupczynski, Y %K 2015 %K antibiotiques %K Belgique %K étude %K germes résistants %K maisons de repos et de soins %K portage %K prevalence %X

NA

%I WIV-ISP %C Brussels, Belgium %P 64 %8 2016 %G eng %M D/2016/2505/23 %0 Journal Article %J Environ Res %D 2016 %T Mortality related to cold and heat. What do we learn from dairy cattle? %A Cox, Bianca %A Gasparrini, Antonio %A Boudewijn Catry %A Delcloo, Andy %A Bijnens, Esmée %A Vangronsveld, Jaco %A Nawrot, Tim S %K Animals %K Belgium %K Cattle %K Cold Temperature %K Cross-Over Studies %K Dairying %K Extreme Cold %K Extreme Heat %K Female %K Hot Temperature %K Humans %K Multivariate Analysis %K Nonlinear Dynamics %K Seasons %X

Extreme temperatures are associated with increased mortality among humans. Because similar epidemiologic studies in animals may add to the existing evidence, we investigated the association between ambient temperature and the risk of mortality among dairy cattle. We used data on 87,108 dairy cow deaths in Belgium from 2006 to 2009, and we combined a case-crossover design with distributed lag non-linear models. Province-specific results were combined in a multivariate meta-analysis. Relative to the estimated minimum mortality temperature of 15.4°C (75th percentile), the pooled cumulative relative risks over lag 0-25 days were 1.26 (95% CI: 1.11, 1.42) for extreme cold (1st percentile, -3.5°C), 1.35 (95% CI: 1.19, 1.54) for moderate cold (5th percentile, -0.3°C), 1.09 (95% CI: 1.02, 1.17) for moderate heat (95th percentile, 19.7°C), and 1.26 (95% CI: 1.08; 1.48) for extreme heat (99th percentile, 22.6°C). The temporal pattern of the temperature-mortality association was similar to that observed in humans, i.e. acute effects of heat and delayed and prolonged effects of cold. Seasonal analyses suggested that most of the temperature-related mortality, including cold effects, occurred in the warm season. Our study reinforces the evidence on the plausibility of causal effects in humans.

%B Environ Res %V 149 %P 231-238 %8 2016 Aug %G eng %1 http://www.ncbi.nlm.nih.gov/pubmed/27236362?dopt=Abstract %R 10.1016/j.envres.2016.05.018 %0 Report %D 2016 %T Nationale prevalentiestudie van dragerschap van resistente bacteriën bij bewoners van woonzorgcentra in België in 2015: eindrapport - juli 2016 %A Beatrice Jans %A Katrien Latour %A Boudewijn Catry %A Argudin, M. %A Deplano,A. %A Dodémont, M %A Nonhoff,C. %A Roisin, S %A Denis, O %A Loens, K %A Ieven, M %A Goossens, H %A D Huang, T-D %A Berhin,C. %A Bogaerts, P %A Schoevaerdts, D %A Glupczynski, Y %K 2015 %K België %K bewoners %K dragerschap %K prevalentiestudie %K resistente bacteriën %K woonzorgcentra %X

NA

%I WIV-ISP %C Brussels, Belgium %P 64 %8 2016 %G eng %M D/2016/2505/24 %0 Journal Article %J Vlaams Diergeneeskundig Tijdschrift %D 2016 %T Risico op colistineresistentie neemt toe %A Bénédicte Callens %A Haesebrouck,F. %A Dewulf,J. %A Boyen,F. %A Butaye,P. %A Boudewijn Catry %A P Wattiau %A E. De Graef %K colistine %K resistentie %K risico %X

In a recent article from China, a transferable resistance mechanism has been described in Escherichia
coli (E. coli), isolated from food-producing animals, meat and hospital patients (Liu et al., 2015).
Recently, this resistance mechanism has also been found in Denmark, France, the United Kingdom and
Belgium. Colistin is considered as one of the last resort treatments against multi-resistant bacteria in
human medicine, especially for patients with cystic fibrosis. Alertness is needed and the new resistance
mechanism has to be detected properly in animal and human related bacteria.

%B Vlaams Diergeneeskundig Tijdschrift %V 85 %8 2016 %G eng %& 36 %R NA %0 Journal Article %J Infect Control Hosp Epidemiol %D 2016 %T Validation of a Sampling Method to Collect Exposure Data for Central-Line-Associated Bloodstream Infections. %A Hammami, Naïma %A Karl Mertens %A Overholser, Rosanna %A Goetghebeur, Els %A Boudewijn Catry %A Marie-Laurence Lambert %K Bacteremia %K Belgium %K Catheterization, Central Venous %K Cross Infection %K hospitals %K Humans %K intensive care units %K Linear Models %K Selection Bias %K Time Factors %X

OBJECTIVE: Surveillance of central-line-associated bloodstream infections requires the labor-intensive counting of central-line days (CLDs). This workload could be reduced by sampling. Our objective was to evaluate the accuracy of various sampling strategies in the estimation of CLDs in intensive care units (ICUs) and to establish a set of rules to identify optimal sampling strategies depending on ICU characteristics.

DESIGN: Analyses of existing data collected according to the European protocol for patient-based surveillance of ICU-acquired infections in Belgium between 2004 and 2012.

SETTING AND PARTICIPANTS: CLD data were reported by 56 ICUs in 39 hospitals during 364 trimesters.

METHODS: We compared estimated CLD data obtained from weekly and monthly sampling schemes with the observed exhaustive CLD data over the trimester by assessing the CLD percentage error (ie, observed CLDs - estimated CLDs/observed CLDs). We identified predictors of improved accuracy using linear mixed models.

RESULTS: When sampling once per week or 3 times per month, 80% of ICU trimesters had a CLD percentage error within 10%. When sampling twice per week, this was >90% of ICU trimesters. Sampling on Tuesdays provided the best estimations. In the linear mixed model, the observed CLD count was the best predictor for a smaller percentage error. The following sampling strategies provided an estimate within 10% of the actual CLD for 97% of the ICU trimesters with 90% confidence: 3 times per month in an ICU with >650 CLDs per trimester or each Tuesday in an ICU with >480 CLDs per trimester.

CONCLUSION: Sampling of CLDs provides an acceptable alternative to daily collection of CLD data.

%B Infect Control Hosp Epidemiol %V 37 %P 549-54 %8 2016 May %G eng %N 5 %1 http://www.ncbi.nlm.nih.gov/pubmed/26758037?dopt=Abstract %& 549 %R 10.1017/ice.2015.344 %0 Journal Article %J Noso info %D 2015 %T Augmentation des infections à Clostridium difficile dans les hôpitaux Belges: données de surveillance 2007-2013 %A Neely,F.N. %A M. Delmée %A J. Van Broeck %A Boudewijn Catry %A Marie-Laurence Lambert %K a %K Belge %K België %K Belgique %K Belgium %K Canada %K ce %K Clostridium %K Clostridium difficile %K Colitis %K complications %K d %K de %K Digestive %K EN %K epidemiology %K ET %K Europe %K fn %K hôpitaux %K infecties %K INFECTION %K infections %K IS %K LE %K PAR %K pathogène %K Surveillance %X L'enquête de prévalence menée en Europe en 2013 a identifié %B Noso info %V Juin 2015 %8 0/1/2015 %G eng %1 31507 %0 Journal Article %J BMJ Open %D 2015 %T The Belgian policy of funding antimicrobial stewardship in hospitals and trends of selected quality indicators for antimicrobial use, 1999-2010: a longitudinal study. %A Marie-Laurence Lambert %A Bruyndonckx, Robin %A Goossens, Herman %A Hens, Niel %A Aerts, Marc %A Boudewijn Catry %A Neely, Fiona %A Vogelaers, Dirk %A Hammami, Naïma %K Anti-Bacterial Agents %K Belgium %K Cefazolin %K Female %K Financing, Government %K Hospital Costs %K Hospitalization %K hospitals %K Humans %K Longitudinal Studies %K Lower Extremity %K Male %K Orthopedic Procedures %K Pneumonia %K POLICY %K Postoperative Complications %K Quality Indicators, Health Care %K Risk Adjustment %X

OBJECTIVES: In order to improve antimicrobial (AM) use, a policy of providing technical and financial support to AM management teams (AMTs) was rolled out in all Belgian hospitals between 2002 and 2008. We aimed to analyse the association of this policy with AM use for the two indications accounting for the largest number of patients receiving AM: prophylaxis for major lower limb orthopaedic surgery and pneumonia.

DESIGN, SETTING, PARTICIPANTS: We used patient-level data routinely collected in all Belgian acute care hospitals between 1999 and 2010. We modelled trends for selected quality indicators (QIs) using the year of AMT implementation in each hospital as the main 'change point', with fine-tuned case-mix adjustment. Of all admissions for lower limb orthopaedic surgery, and pneumonia between 1999 and 2010, 90% (325 094) and 95% (327 635), respectively, were found eligible for analyses.

OUTCOMES: The surgery QI was defined as: cefazolin, dose in the expected range, and no use of other AM. For pneumonia, QIs were: ratio of oral/parenteral defined daily doses (DDD, O/P QI), and mean number of DDD minus penicillin, per 100 days of hospitalisation (DDD QI).

RESULTS: Between 1999 and 2010, the surgery QI improved from 59% to 71%, the O/P QI from 0.72 to 0.97, and the DDD QI from 96 to 64. Heterogeneity between hospitals was high. Overall, no association was found with the year of implementation of the AMT.

CONCLUSIONS: Improvements have been observed but could not be related at the national level to the policy under study. However, these results cannot be extrapolated to other QIs for AM use in hospitals. Our findings do not question the need for AMT, nor the need for continuation of AMT funding. Several recommendations can be made in order to make the best of Belgium's unique political and financial commitments in that field.

%B BMJ Open %V 5 %P e006916 %8 2015 Feb 13 %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/25681314?dopt=Abstract %& e006916 %R 10.1136/bmjopen-2014-006916 %0 Generic %D 2015 %T Epidemiology of urinary tract infections %A Katrien Latour %A Jans, B %A Boudewijn Catry %K healthcare-associated infections %K hospitals %K nursing homes %K urinary tract infection %B Infections urinaires: comment prévenir? Urineweginfecties: hoe te voorkomen? %I Belgian Infection Control Society %C Brussels, Belgium %8 28/5/2015 %G eng %N Belgian Infection Control Society %1

31487

%2 28/05/2015 %0 Report %D 2015 %T Indicateurs de qualité en hygiène hospitalière dans les hôpitaux aigus: rapport annuel - données 2013 %A Marie-Laurence Lambert %A Boudewijn Catry %K 2013 %K hôpitaux aigus %K Indicateurs %K qualité en hygiène hospitalière %X

Contexte et introduction
L’Arrêté Royal du 19/06/2007 concernant la surveillance en hygiène hospitalière mentionne l’obligation pour les hôpitaux de récolter des indicateurs de qualité relatifs à la politique d’hygiène hospitalière dans l’établissement. Les objectifs précis et les indicateurs ont été élaborés en 2011 par un groupe de travail coordonné par l’Institut Scientifique de la Santé Publique (WIV-ISP) et impliquant les acteurs de terrain au travers des plateformes en hygiène hospitalière ainsi que le Service Public Fédéral Santé Publique (Belgian Antibiotic Policy Coordination Committee).
Trois objectifs ont été définis :

La première récolte de données a été clôturée en janvier 2015 (données 2013). Ce rapport présente les résultats agrégés en rapport avec l’objectif 1 ainsi qu’une liste nominative des hôpitaux avec leur résultats résumés (scores), en rapport avec l’objectif 2.

%I WIV-ISP %C Brussels, Belgium %P 44 %8 11/2015 %G eng %M NA %0 Journal Article %J Acta Clin Belg %D 2015 %T Infection due to travel-related carbapenemase-producing Enterobacteriaceae, a largely underestimated phenomenon in Belgium. %A Jans, B %A D Huang, T-D %A Bauraing, C %A Berhin, C %A Bogaerts, P %A Deplano, A %A Denis, O %A Boudewijn Catry %A Glupczynski, Y %K Bacterial Proteins %K Belgium %K beta-Lactamases %K Cross Infection %K Enterobacteriaceae %K Enterobacteriaceae Infections %K Humans %K Infection Control %K Microbial Sensitivity Tests %K Needs Assessment %K Risk Assessment %K Travel %X

BACKGROUND: Carbapenemase-producing Enterobacteriaceae (CPE) are emerging worldwide, representing a major threat for public health. Early CPE detection is crucial in order to prevent infections and the development of reservoirs/outbreaks in hospitals. In 2008, most of the CPE strains reported in Belgium were imported from patients repatriated from abroad. Actually, this is no longer the case.

OBJECTIVES AND METHODS: A surveillance was set up in Belgian hospitals (2012) in order to explore the epidemiology and determinants of CPE, including the link with international travel/hospitalization. The present article describes travel-related CPE reported in Belgium. Different other potential sources for importation of CPE are discussed.

RESULTS: Only 12% of all CPE cases reported in Belgium (2012-2013) were travel related (with/without hospitalization). This is undoubtedly an underestimation (missing travel data: 36%), considering the increasing tourism, the immigration from endemic countries, the growing number of foreign patients using scheduled medical care in Belgium, and the medical repatriations from foreign hospitals. The free movement of persons and services (European Union) contributes to an increase in foreign healthcare workers (HCW) in Belgian hospitals. Residents from nursing homes located at the country borders can be another potential source of dissemination of CPE between countries. Moreover, the high population density in Belgium can increase the risk for CPE-dissemination. Urban areas in Belgium may cumulate these potential risk factors for import/dissemination of CPE.

CONCLUSIONS: Ideally, travel history data should be obtained from hospital hygiene teams, not from the microbiological laboratory. Patients who received medical care abroad (whatever the country) should be screened for CPE at admission.

%B Acta Clin Belg %V 70 %P 181-7 %8 2015 Jun %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/25825036?dopt=Abstract %& 181 %R 10.1179/2295333715Y.0000000001 %0 Report %D 2015 %T Kwaliteitsindicatoren voor ziekenhuishygiëne in acute ziekenhuizen: jaarrapport - data 2013 %A Marie-Laurence Lambert %A Boudewijn Catry %K 2013 %K acute ziekenhuizen %K Kwaliteitsindicatoren %K ziekenhuishygiëne %X

Context en inleiding
Het Koninklijk Besluit van 19 juni 2007 betreffende het toezicht op ziekenhuishygiëne bepaalt dat ziekenhuizen verplicht zijn om de kwaliteitsindicatoren met betrekking tot het ziekenhuishygiënebeleid in de instelling te verzamelen. De precieze doelstellingen en de indicatoren zijn in 2011 uitgewerkt door een werkgroep, gecoördineerd door het Wetenschappelijk Instituut Volksgezondheid (WIV-ISP), waarbij de actoren op het terrein -via platformen voor ziekenhuishygiëne- en de Federale Overheidsdienst Volksgezondheid (Belgian Antibiotic Policy Coordination Committee, BAPCOC) betrokken zijn.
Er zijn drie doelstellingen vooropgesteld:

De eerste gegevensverzameling is afgerond in januari 2015 (gegevens van 2013). In dit rapport staan de geaggregeerde resultaten in verband met doelstelling 1 alsook een lijst met de naam van de ziekenhuizen en een samenvatting van hun resultaten (scores) in verband met doelstelling 2 (tekstformaat).

%I WIV-ISP %C Brussels, Belgium %P 44 %8 11/2015 %G eng %M NA %0 Report %D 2015 %T National report on consumption of systemic antimicrobial agents in Belgian hospitals: 2007-2013 %A Ingenbleek, Anne %A E Van Gastel %A Costers, M %A Goossens, M.-M. %A Boudewijn Catry %A Magerman,K. %K antimicrobial agents %K Belgium %K CONSUMPTION %K hospitals %K report %K systemic %X

NA

%I WIV-ISP %C Brussels, Belgium %P 53 %8 09/2015 %G eng %M D/2015/2505/57 %0 Journal Article %J Transbound.Emerg.Dis. %D 2015 %T Nosocomial Intravascular Catheter Infections with Extended-spectrum Beta-lactamase-producing Escherichia coli in Calves after Strain Introduction from a Commercial Herd %A Pardon,B. %A Smet,A. %A Butaye,P. %A Argudin,M.A. %A Valgaeren,B. %A Boudewijn Catry %A Haesebrouck,F. %A Deprez,P. %K a %K admission %K ALL %K an %K Animal %K Animals %K Antimicrobial %K Antimicrobial resistance %K antimicrobial use %K article %K bacteria %K Belgium %K Brussels %K care %K Case %K Catheter-Related Infections %K clinic %K danger %K disease %K Diseases %K dissemination %K e %K electronic %K Electrophoresis %K environment %K Escherichia coli %K evidence %K Faculty %K food %K gene %K health %K health care %K Health care associated %K HEALTH-CARE %K hospital %K Hospitalization %K immunology %K INFECTION %K infections %K Institute %K internal medicine %K IS %K journal %K Medicine %K mortality %K NEONATAL %K nosocomial %K ON %K ORIGIN %K outbreak %K pathology %K public %K public health %K Public-health %K report %K resistance %K strain %K teaching %K Universities %K university %K use %K veterinary %K Veterinary Medicine %K WIV-ISP %X An outbreak of intravascular catheter-related infections by extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli in calves in an animal teaching hospital is reported. Pulsed-field gel electrophoresis was used for strain typing to determine the origin and dissemination of these strains. All 19 strains harboured the blaCTX -M-14, and six strains also overexpressed their chromosomal AmpC gene. Evidence on the introduction of the strain from a beef herd, experiencing neonatal diarrhoea and increased mortality, to the clinic through admission of diarrhoeic calves was provided. Strains isolated from phlebitis cases from other herds up to 5 months later showed a high similarity with the initial strain, suggesting that the strain had become nosocomial. The catheter infections with ESBL/AmpC-producing E. coli resulted in a prolonged hospitalization, increased anti-microbial use and mortality. This report points towards the potential dangers of the emergence of ESBL/AmpC-producing bacteria in susceptible food animals and warns farmers and veterinarians for the facility by which they are introduced into another environment %B Transbound.Emerg.Dis. %V tbc %P tbc - tbc %8 22/4/2015 %G eng %N tbc %1 31585 %& tbc %R http://dx.doi.org/10.1111/tbed.12352 %0 Journal Article %J Microb Drug Resist %D 2015 %T Presence of antimicrobial resistance and antimicrobial use in sows are risk factors for antimicrobial resistance in their offspring. %A Bénédicte Callens %A Faes, Christel %A Maes, Dominiek %A Boudewijn Catry %A Boyen, Filip %A Francoys, Delphine %A de Jong, Ellen %A Haesebrouck, Freddy %A Dewulf, Jeroen %K Animals %K Anti-Bacterial Agents %K Belgium %K Disease Reservoirs %K Drug Resistance, Microbial %K Drug Utilization %K Escherichia coli %K Escherichia coli Infections %K Feces %K Female %K Infectious Disease Transmission, Vertical %K Postpartum Period %K Pregnancy %K Selection, Genetic %K Sus scrofa %K Swine %K Swine Diseases %K Weaning %X

This study investigated whether antimicrobial-resistant Escherichia coli in apparently healthy sows and antimicrobial administration to sows and piglets influenced antimicrobial resistance in fecal commensal E. coli from piglets. Sixty sows from three herds and three of their piglets were sampled at several time points. Antimicrobial usage data during parturition and farrowing were collected. Clinical resistance was determined for two isolates per sampling time point for sows and piglets using disk diffusion. Only 27.4% of E. coli isolates from newborn piglets showed no resistance. Resistance to one or two antimicrobial classes equaled 41.2% and 46.8% in isolates from sows and piglets, respectively, for the overall farrowing period. Multiresistance to at least four classes was found as frequently in sows (15.6%) as in piglets (15.2%). Antimicrobial resistance in piglets was influenced by antimicrobial use in sows and piglets and by the sow resistance level (p≤0.05). Using aminopenicillins and third-generation cephalosporins in piglets affected resistance levels in piglets (odds ratios [OR] >1; p≤0.05). Using enrofloxacin in piglets increased the odds for enrofloxacin resistance in piglets (OR=26.78; p≤0.0001) and sows at weaning (OR=4.04; p≤0.05). For sows, antimicrobial exposure to lincomycin-spectinomycin around parturition increased the resistance to ampicillin, streptomycin, trimethoprim-sulfadiazine in sows (OR=21.33, OR=142.74, OR=18.03; p≤0.05) and additionally to enrofloxacin in piglets (OR=7.50; p≤0.05). This study demonstrates that antimicrobial use in sows and piglets is a risk factor for antimicrobial resistance in the respective animals. Moreover, resistance determinants in E. coli from piglets are selected by using antimicrobials in their dam around parturition.

%B Microb Drug Resist %V 21 %P 50-8 %8 2015 Feb %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/25098762?dopt=Abstract %R 10.1089/mdr.2014.0037 %0 Report %D 2015 %T Resultaten van de 6e nationale campagne ter bevordering van de handhygiëne in ziekenhuizen, 2014-2015 %A Sylvanus Fonguh %A Boudewijn Catry %K 2014 %K 2015 %K Campagne %K handhygiëne in ziekenhuizen %K Resultaten %X

H
ealthcare-associated infections are among the top 10 causes of hospital deaths worldwide [1]. According to the last point prevalence survey in Belgium executed in 2011, the prevalence rate of infected patients in Belgian acute care hospitals was 7.1% (95% confidence interval 6.1-8.3), resulting in an annual estimate of over 111,000 (95% confidence interval 73,556-159,292) infected patients in this setting [2]. Hand hygiene (HH ) compliance has been recognised as the most important factor in preventing transmission of infection to patients in healthcare settings [3-6]. Unfortunately HH compliance of healthcare workers, especially physicians, still remains suboptimal [7, 8].
C
ountrywide hand hygiene campaigns have been organised since 2005 in Belgium, with multiple target groups and different focus depending on the outcome of the previous campaign [7]. These campaigns aimed at raising awareness on good HH practices and promoting the use of alcohol based hand rubs. The 6th campaign focused on the active participation of the patient and their families, with campaign message being “Hand Hygiene, Together with the Patient”. The methodology of the campaign was the same as for the previous campaigns, with direct observation using a standardized roster with the help since the 5th campaign of an online data collection tool that is compatible with wireless tablets and provides real-time performance feedback to the hospitals [9].
A
total of 152/193 (78.7%) hospitals delivered before (pre) campaign compliance observations (123 acute care hospitals, 11 chronic care hospitals and 18 psychiatric hospitals) and 141 hospitals introduced after (post) campaign observations (115 acute care hospitals, 9 chronic care hospitals and 17 psychiatric hospitals; Table 1). A total of 136 hospitals provided data both before and after campaign, thus for comparison between before and after only data from 136 hospitals were used. A summary of the results from both pre and post campaign can be found in annex 1. HH compliance (national weighted mean) increased significantly from 69.1% before to 77.7% post campaign (P <0.0001). Compliance rate increased for all types of healthcare workers (around 6% to 12%), with nurses performing best and physicians still low (Figure 9). As concerns the different types of services, there was a general increase in compliance rates with the highest rates recorded in pediatric/neonatal and intensive care units (Figure 4). Compared to the previous campaign, compliance rate was still substantially higher for ‘after patient contact’ and ‘exposure to body fluids’, compared to ‘before patient contact’, implying that healthcare workers consistently tend to protect themselves more or less than to protect the patient, as earlier explained [7].
In conclusion, the sixth national campaign was another success in terms of very high participation rates, and a marked increase in compliance rate bypassing the historical 70% margin by 7.7%. The main factors for this success could be explained by the multimodal methodology of the awareness campaign, the repetition of the campaign, the nation-wide scale of the campaign and the political and financial support of the federal government. In addition a user friendly online tool for data entry and real-time local feedbacks to the hospitals may have contributed to its success. Lower compliance rates among physicians compared to nurses, before patient contact and before performing aseptic procedures still remain challenges for future campaigns.

%I WIV-ISP %C Brussels, Belgium %P 40 %8 12/2015 %G eng %M D/2015/2505/81 %0 Report %D 2015 %T Résultats de la 6e campagne nationale pour la promotion de l'hygiène des mains dans les hôpitaux 2014-2015 %A Sylvanus Fonguh %A Boudewijn Catry %K 2014 %K 2015 %K Campagne %K hygiène des mains %K résultats %X

Healthcare-associated infections are among the top 10 causes of hospital deaths worldwide [1]. According to the last point prevalence survey in Belgium executed in 2011, the prevalence rate of infected patients in Belgian acute care hospitals was 7.1% (95% confidence interval 6.1-8.3), resulting in an annual estimate of over 111,000 (95% confidence interval 73,556-159,292) infected patients in this setting [2]. Hand hygiene (HH) compliance has been recognised as the most important factor in preventing transmission of infection to patients in healthcare settings [3-6]. Unfortunately HH compliance of healthcare workers, especially physicians, still remains suboptimal [7, 8].
Countrywide hand hygiene campaigns have been organised since 2005 in Belgium, with multiple target groups and different focus depending on the outcome of the previous campaign [7]. These campaigns aimed at raising awareness on good HH practices and promoting the use of alcohol based hand rubs. The 6th campaign focused on the active participation of the patient and their families, with campaign message being “Hand Hygiene, Together with the Patient”. The methodology of the campaign was the same as for the previous campaigns, with direct observation using a standardized roster with the help since the 5th campaign of an online data collection tool that is compatible with wireless tablets and provides real-time performance feedback to the hospitals [9].
A total of 152/193 (78.7%) hospitals delivered before (pre) campaign compliance observations (123 acute care hospitals, 11 chronic care hospitals and 18 psychiatric hospitals) and 141 hospitals introduced after (post) campaign observations (115 acute care hospitals, 9 chronic care hospitals and 17 psychiatric hospitals; Table 1). A total of 136 hospitals provided data both before and after campaign, thus for comparison between before and after only data from 136 hospitals were used. A summary of the results from both pre and post campaign can be found in annex 1. HH compliance (national weighted mean) increased significantly from 69.1% before to 77.7% post campaign (P <0.0001). Compliance rate increased for all types of healthcare workers (around 6% to 12%), with nurses performing best and physicians still low (Figure 9). As concerns the different types of services, there was a general increase in compliance rates with the highest rates recorded in pediatric/neonatal and intensive care units (Figure 4). Compared to the previous campaign, compliance rate was still substantially higher for ‘after patient contact’ and ‘exposure to body fluids’, compared to ‘before patient contact’, implying that healthcare workers consistently tend to protect themselves more or less than to protect the patient, as earlier explained [7].
In conclusion, the sixth national campaign was another success in terms of very high participation rates, and a marked increase in compliance rate bypassing the historical 70% margin by 7.7%. The main factors for this success could be explained by the multimodal methodology of the awareness campaign, the repetition of the campaign, the nation-wide scale of the campaign and the political and financial support of the federal government. In addition a user friendly online tool for data entry and real-time local feedbacks to the hospitals may have contributed to its success. Lower compliance rates among physicians compared to nurses, before patient contact and before performing aseptic procedures still remain challenges for future campaigns.

%I WIV-ISP %C Brussels, Belgium %P 44 %8 2015 %G eng %M D/2015/2505/80 %0 Government Document %D 2015 %T Septicemieën geassocieerd aan een centraal veneuze katheter in de Belgische ziekenhuizen: surveillancegegevens 2000 - 2014 %A Hammami, Naïma %A Boudewijn Catry %A Marie-Laurence Lambert %K Belgian %K Bloodstream infection %K Bloodstream infections %K data %K hospital %K hospitals %K INFECTION %K infections %K report %K Surveillance %X

NA

%B NosoInfo %I UCL %C Brussel %V 19 %8 2015 %G eng %N 3 %& 2 %0 Government Document %D 2015 %T Septicémies associées aux cathéters veineux centraux dans les hôpitaux Belges : données de surveillance 2000 – 2014 %A Hammami, Naïma %A Boudewijn Catry %A Marie-Laurence Lambert %K Belgian %K Bloodstream infection %K Bloodstream infections %K data %K hospital %K hospitals %K INFECTION %K infections %K report %K Surveillance %X

NA

%B Noso-Info %I UCL %C Bruxelles %V 19 %8 2015 %G eng %N 3 %& 2 %0 Journal Article %J Arch Public Health %D 2015 %T Surveillance of Clostridium difficile infections in a long-term care psychogeriatric facility: outbreak analysis and policy improvement. %A Van Esch, Gretel %A Van Broeck, Johan %A Delmée, Michel %A Boudewijn Catry %X

BACKGROUND: Following an exceptionally high Clostridium difficile infections (CDI) incidence (Spring 2011) in a psychogeriatric long-term care facility, a bidirectional study (2009-2012) was initiated to identify determinants (retrospectively) and to assess intervention measures taken (prospectively).

METHODS: For every CDI patient (de novo cases, relapses, and recurrences), a control patient (patient in the opposite room) was selected and risk factor analysis performed. Following the epidemic peak a more stringent hygienic protocol and surveillance program were implemented, as well as uniform guidelines for metronidazole and vancomycin prescription.

RESULTS: The nutritional state (total protein/prealbumine) significantly differed between the CDI group (poorer nutritional state at admission) and the control group, and also antibiotic use (general) could be confirmed as a risk factor. A multi-disciplinary nutritional team has been established in order to improve the nutritional balance of our patients.

CONCLUSIONS: Aside from stringent hygiene and antibiotic prescription stewardship, malnutrition of patients is a factor to be taken into account to contain a CDI outbreak in a long term care facility (LTCF).

%B Arch Public Health %V 73 %P 18 %8 2015 %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/25922669?dopt=Abstract %R 10.1186/s13690-015-0067-y %0 Generic %D 2015 %T Trends in candidaemia and antifungal consumption in Belgium %A Berdieke Goemaere %A Pierre Becker %A A Ingenbleek %A Boudewijn Catry %A Marijke Hendrickx %A K. Lagrou %K Belgium %K CONSUMPTION %K medical %K Medical mycology %K Mycology %K trend %K trends %B 7th Trends in Medical Mycology %I NA %C NA %8 0/0/2015 %G eng %N EORTC, ECMM %1 38209 %2 09-12/10/2015 %0 Journal Article %J Int J Antimicrob Agents %D 2015 %T Use of colistin-containing products within the European Union and European Economic Area (EU/EEA): development of resistance in animals and possible impact on human and animal health. %A Boudewijn Catry %A Cavaleri, Marco %A Baptiste, Keith %A Grave, Kari %A Grein, Kornelia %A Holm, Anja %A Jukes, Helen %A Liebana, Ernesto %A Lopez Navas, Antonio %A Mackay, David %A Magiorakos, Anna-Pelagia %A Miguel Angel Moreno Romo %A Moulin, Gérard %A Muñoz Madero, Cristina %A Matias Ferreira Pomba, Maria Constança %A Powell, Mair %A Pyörälä, Satu %A Rantala, Merja %A Ruzauskas, Modestas %A Sanders, Pascal %A Teale, Christopher %A Threlfall, Eric John %A Törneke, Karolina %A van Duijkeren, Engeline %A Jordi Torren Edo %K Acinetobacter baumannii %K Animals %K Anti-Bacterial Agents %K Bacterial Infections %K Chemoprevention %K Colistin %K Drug Resistance, Bacterial %K Enterobacteriaceae %K European Union %K Humans %K Pseudomonas aeruginosa %X

Since its introduction in the 1950s, colistin has been used mainly as a topical treatment in human medicine owing to its toxicity when given systemically. Sixty years later, colistin is being used as a last-resort drug to treat infections caused by multidrug-resistant (MDR) Pseudomonas aeruginosa, Acinetobacter baumannii and Enterobacteriaceae (e.g., Escherichia coli, Klebsiella pneumoniae), for which mortality can be high. In veterinary medicine, colistin has been used for decades for the treatment and prevention of infectious diseases. Colistin has been administered frequently as a group treatment for animal gastrointestinal infections caused by Gram-negative bacteria within intensive husbandry systems. Given the ever-growing need to retain the efficacy of antimicrobials used to treat MDR infections in humans, the use of colistin in veterinary medicine is being re-evaluated. Despite extensive use in veterinary medicine, there is limited evidence for the development of resistance to colistin and no evidence has been found for the transmission of resistance in bacteria that have been spread from animals to humans. Since surveillance for colistin resistance in animals is limited and the potential for such transmission exists, there is a clear need to reinforce systematic monitoring of bacteria from food-producing animals for resistance to colistin (polymyxins). Furthermore, colistin should only be used for treatment of clinically affected animals and no longer for prophylaxis of diseases, in line with current principles of responsible use of antibiotics.

%B Int J Antimicrob Agents %V 46 %P 297-306 %8 2015 Sep %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/26215780?dopt=Abstract %& 297 %R 10.1016/j.ijantimicag.2015.06.005 %0 Report %D 2014 %T Antimicrobial consumption in Belgian hospitals for selected diagnoses, 1999-2010, and association with policies aimed at promoting rational use. %A Marie-Laurence Lambert %A N Hammami %A Boudewijn Catry %A Bruyndonckx,R. %A Aerts,M %A N. Hens %K Antimicrobial %K antimicrobial use %K association %K at %K Belgian %K CONSUMPTION %K hospital %K hospitals %K POLICIES %K POLICY %K SELECTED %K use %I WIV-ISP %C Brussels %P 72 %8 1/3/2014 %@ D/2014/2505/07 %G eng %1 37995 %0 Generic %D 2014 %T Burkholderia incident in Belgian Hospitals %A Jans,B. %A Denis Piérard %A A. De Bel %A Vrindts,E. %A Boudewijn Catry %A Vandamme,P. %E WIV-ISP %E Séminaire de Microbiologie et de Maladies Infectieuses %K a %K ALL %K an %K analysi %K analysis %K AS %K at %K bacteria %K Belgian %K Belgium %K burkholderia %K care %K Case %K Clinical %K Clinical samples %K colonisation %K Components %K consumer %K Cystic Fibrosis %K delivery %K environment %K environmental %K ENVIRONMENTAL-SAMPLES %K EPIDEMIOLOGICAL %K Fibrosis %K Gram-Negative Bacteria %K Hand %K Hand hygiene %K health %K healthcare %K HEALTHCARE WORKERS %K hospital %K hospitals %K Human %K Humans %K Hygiene %K illness %K illnesses %K incidence %K incident %K INFECTION %K infections %K intensive care %K intensive care unit %K intensive care units %K investigation %K IS %K Lead %K national %K ON %K oral presentation %K pathogenic %K Patient %K patients %K Pneumonia %K PRESENTATION %K PROCESSES %K production %K PRODUCTS %K public %K Recall %K Sample %K Samples %K Service %K Sites %K strain %K survey %K treatment %K use %K WHO %K WIV-ISP %K worker %K Workers %X Burkholderia %B Burkholderia incident in Belgian Hospitals %C Cultureel en congrescentrum Sint-Pieters-Woluwe %8 27/11/2014 %G eng %N WIV-ISP, Séminaire de Microbiologie et de Maladies Infectieuses %1 31591 %2 27/11/2014 %0 Journal Article %J Noso-Info %D 2014 %T Entérobactéries productrices de carbapénémases importées: contexte belge %A Jans,B. %A T-D. D. Huang %A Bauraing,C. %A Berhin,C. %A P Bogaerts %A Deplano,A. %A O. Denis %A Boudewijn Catry %A Y. Glupczynski %K 2012 %K a %K article %K Belge %K Belgique %K CONTACT %K CONTACTS %K CPE %K de %K EN %K ET %K LE %K MDRO %K Patient %K programme %K santé %K Surveillance %K Transmission %K Travel %X Le programme de surveillance active des CPE en Belgique initié en 2012 a permis d'estimer la proportion des cas de CPE liés à l'étranger dans notre pays. Le présent article souligne les limites de cette surveillance (36% de données manquantes) et passe en revue d'autres sources potentielles d'importation de CPE, liées ou non à des contacts avec les soins de santé à l'étranger.Il semble prudent de considérer aujourd'hui comme à risque accru de portage de CPE (et d'autres MDRO) tout patient ayant reçu des soins de santé dans un établissement à l'étranger, quel que soit le pays considéré, même si il est probable que le niveau de risque puisse être très différent selon les zones géographiques considérées. %B Noso-Info %V XVIII %P 7 - 13 %8 1/12/2014 %G eng %N Number 4 %1 31592 %& 7 %0 Generic %D 2014 %T Epidemiological surveillance of OXA-48 type carbapenemase-producing Enterobacteriaceae in Belgium: Surveillance data 2012-2013 %A Jans,B. %A Boudewijn Catry %K Antimicrobial resistance %K Belgium %K Clinical %K Congresses %K data %K disease %K Diseases %K Enterobacteriaceae %K EPIDEMIOLOGICAL %K European %K hospital %K Infectious %K Infectious diseases %K microbiology %K Surveillance %K Type %B 24th European Congress of Clinical Microbiology and Infectious Diseases %I NA %C NA %8 0/0/2014 %G eng %N European Society of Clinical Microbiology and Infectious Diseases %1 31475 %2 12/05/2014 %0 Report %D 2014 %T Epidémiologie des infections à Clostridium difficile en Belgique: Rapport 2014 %A Neely,F.N. %A Marie-Laurence Lambert %A Boudewijn Catry %K Belgique %K Clostridium %K Clostridium difficile %K de %K EN %K fn %K INFECTION %K infections %K rapport %K Surveillance %X

Les infections à Clostridium difficile (ICD) sont une cause majeure de diarrhée et de colite pseudomembraneuse dans les institutions de soin aigus et chroniques. Dans la dernière décennie, une augmentation de l’incidence a été rapportée dans divers pays du monde. Cette augmentation a été attribuée à de multiples facteurs: une augmentation de l’utilisation de certains antibiotiques, une augmentation de la population présentant des facteurs de risque (les personnes âgées), et l’émergence de souches hypervirulentes.
Ce rapport fait la synthèse des différentes sources de données disponibles quant à l’épidémiologie des ICD en Belgique: données de la surveillance nationale dans les hôpitaux, y compris les données du laboratoire de référence (2007-2013), les données des résumés hospitaliers minima (RHM 1999 -2011), et les données des registres des décès (1998-2010). Ces différentes sources confirment une augmentation importante de la morbidité et de la mortalité liées aux ICD à partir de 2002-2003. La mortalité a atteint un pic en 2004 (avec une augmentation particulièrement importante à Bruxelles), et a fortement diminué depuis. En 2010, le taux brut de mortalité spécifique (décès attribués à une entérocolite à Clostridium difficile) était de 0.9 /100.000 habitants. Ce taux était le plus élevé à Bruxelles et le plus bas en Wallonie.
Le pic d’incidence observé en 2008 s’est stabilisé à un niveau élevé. En 2013, l’incidence moyenne des ICD pour 105 hôpitaux ayant rapporté des données pendant 12 mois était de 1.65 épisodes / 1000 admissions, le taux le plus élevé depuis 2009 ; l’incidence moyenne des ICD acquises à l’hôpital (c’est-à-dire, avec début des symptômes 2 jours ou plus après admission à l’hôpital déclarant) était de 1.0 /1000 admissions. (A titre de comparaison, l’incidence des infections nosocomiales à MRSA - échantillons cliniques - était de 1.1/1000 admissions en 2012). L’incidence des ICD acquises à l’hôpital en 2013 était la plus élevée à Bruxelles et la plus basse en Flandre.
Les dernières données de surveillance suggèrent une légère augmentation de la proportion des épisodes avec début des symptômes dans la communauté, ce qui a été rapporté dans d’autres pays. Les autres caractéristiques des cas semblent stables depuis le début de la surveillance (âge, sexe, proportion des cas supposés provenir d’institutions de soins chroniques).
L’incidence des ICD est saisonnière, avec un pic en mars-avril. Il existe une grande variabilité d’incidence entre les hôpitaux, ce qui suggère un important potentiel de prévention.
Le typage de 585 souches de Clostridium difficile provenant de 103 hôpitaux différents a identifié 133 ribotypes différents, dont 72 n’ont été isolés qu’une seule fois, et 60 n’avaient jamais été isolés en Belgique auparavant. Ceci illustre la multiplicité des sources de transmission. Les ribotypes les plus fréquemment isolés étaient les ribotypes O14 (8% du total des souches typées) et 020 (7%). La proportion des hôpitaux avec une souche hypervirulente 027 est passée de 34% en 2009 à 15% en 2013. Une diminution de la prévalence du ribotype 027 a été rapportée également au Royaume Uni et aux Pays-Bas.
Les comparaisons internationales situent l’incidence des ICD en Belgique dans la moyenne des autres pays européens. Cette incidence est plus basse que l’incidence des ICD aux Etats-Unis. Les dernières données de surveillance semblent indiquer que l’incidence des ICD est à nouveau en augmentation en Europe et en Belgique.

%I WIV-ISP %C Brussels %P 41 %8 0/7/2014 %@ 2034-4562 %G eng %M NA %1 31416 %2 2014-024 %0 Report %D 2014 %T Epidemiologie van Clostridium difficile infecties in België: Rapport 2014 %A Neely,F.N. %A Marie-Laurence Lambert %A Boudewijn Catry %K België %K Clostridium %K Clostridium difficile %K infecties %K rapport %X

Clostridium difficile infecties (CDI) zijn een belangrijke oorzaak van diarree en pseudomembraneuze colitis in acute en chronische zorginstellingen. Tijdens het laatste decennium werd wereldwijd een toename van de incidentie gemeld. Dit was toe te schrijven aan meerdere factoren waaronder een kwetsbaardere en oudere patiëntenpopulatie, toegenomen gebruik van antibiotica die de infectie uitlokken en de opkomst van virulente stammen.
Dit rapport geeft een overzicht van verschillende bronnen die de epidemiologie van CDI beschrijven in België: de gegevens van de verplichte nationale surveillance in ziekenhuizen inclusief de referentielaboratorium data (2007-2013), de Minimale Ziekenhuis Gegevens (MZG) met een diagnose van CDI (1999 -2011) en het algemene overlijdensregister (1998-2010). De verschillende bronnen van gegevens bevestigen een belangrijke toename van de CDI-gerelateerde incidentie en mortaliteit vanaf 2002-2003. De sterfte bereikte een piek in 2004 (in het bijzonder gekenmerkt door een enorme toename in Brussel). In 2010 bedroeg het ruwe specifieke sterftecijfer voor CDI in België 0,9 / 100 000 inwoners, met de hoogste waarde in Brussel en de laagste in Wallonië.
De incidentie van CDI piekte rond 2008 en is, na een periode van afname, gestabiliseerd in 2010-2011. In 2013 was de gemiddelde incidentie van CDI 1,65 episodes / 1000 opnames (gegevens van 105 ziekenhuizen die gegevens leverden voor het hele jaar). Dit is de hoogste incidentie sinds 2009. De gemiddelde incidentie van ziekenhuisverworven CDI (begin van de symptomen > 2 dagen na opname in het declarerende ziekenhuis) was 1,0 / 1000 opnames (ter vergelijking, de incidentie van ziekenhuisverworven MRSA vastgesteld via klinische monsters was 1.1/1000 opnames in 2012). De meest recente gegevens suggereren een lichte stijging van het aandeel van gemeenschap-geassocieerde gevallen, zoals ook beschreven in andere landen. Een vergelijking tussen de regio’s toont dat de incidentie van ziekenhuisverworven CDI in 2013 het hoogst was in Brussel en het laagst in Vlaanderen.
Andere kenmerken van de gevallen zijn vergelijkbaar met de voorgaande jaren - leeftijd, geslacht, het aandeel van recidieven, het aandeel dat een vermoedelijke oorsprong heeft in een chronische zorginstelling.
De incidentie is seizoensgebonden met een piek in maart-april, en zeer variabel tussen ziekenhuizen onderling, wat wijst op een belangrijke mogelijkheid tot verbetering.
Ribotypering van 585 CDI stammen uit 103 verschillende ziekenhuizen resulteerde in 133 verschillende ribotypes, 72 van hen werd slechts één keer geïdentificeerd, en 60 nooit eerder in België. Dit illustreert ook een diversiteit in transmissie oorsprongen. De meest geïsoleerde ribotypes waren O14 (8% van het totaal aantal getypeerde stammen) en 020 (7%). Het aandeel van de ziekenhuizen waarin de hypervirulent ribotype O27 werd aangetroffen daalde van 34% in 2009 naar 15% in 2013. Een daling van de prevalentie van dit ribotype 027 werd ook gemeld in het Verenigd Koninkrijk en Nederland.
Internationale vergelijkingen tonen aan dat België een incidentie van CDI heeft in de mid-range van andere Europese landen en lager dan die in de Verenigde Staten. Er zijn aanwijzingen dat de incidentie van CDI weer stijgt in Europa, net zoals in België.

%I WIV-ISP %C Brussel %P 41 %8 0/7/2014 %@ 2034-4635 %G eng %M NA %1 31467 %2 2014 - 25 %0 Report %D 2014 %T Epidemiology of Clostridium difficile infection in Belgium: Report 2014 %A Neely,F.N. %A Marie-Laurence Lambert %A Boudewijn Catry %K Belgium %K Clostridium %K Clostridium difficile %K epidemiology %K INFECTION %K report %X

Clostridium difficile infection (CDI) is a major cause of diarrhea and pseudomembranous colitis in acute and chronic care healthcare facilities. During the last decade, an increase in the incidence has been reported worldwide. This had been attributed to multiple factors including a more frail and older patient population, increased use of antibiotics that trigger the infection, and the emergence of virulent strains.
This report summarises the different sources of data available to describe the epidemiology of CDI in Belgium: epidemiological data from the mandatory surveillance scheme in hospitals including reference laboratory data (2007-2013), data on hospital discharges with a diagnostic of CDI (1999 -2011) and death registration data (1998-2010). The different sources of data confirm an important increase in CDI related incidence and mortality from 2002-2003 onwards. Mortality attained a peak in 2004, (linked particularly to an enormous increase in Brussels) subsequently followed by a decline. In 2010, the crude specific mortality rate for CDI in Belgium was 0.9 /100 000 inhabitants, highest in Brussels and lowest in Wallonia.
The peak in incidence around 2008 has diminished and stabilised in 2010-2011, but at an elevated level. In 2013, the mean CDI incidence for 105 hospitals contributing data the whole year was 1.65 episodes / 1000 admissions, the highest since 2009. The mean incidence of hospital acquired (HA) CDI (onset of symptoms > 2 days after admission in the declaring hospital) was 1.0 /1000 admissions (As a comparison, incidence of HA-MRSA, clinical samples, was 1.1/1000 admissions in 2012). The latest hospital surveillance data show a slight increase in the proportion of cases which are community-associated, as described in other countries. Incidence of HA CDI in 2013 was highest in Brussels and lowest in Flanders.
Other characteristics of cases have remained comparable to previous years – age, sex, the proportion of recurrences, the proportion thought to originate in long term care facilities.
The incidence is seasonal with a peak in March-April, and highly variable from one hospital to another, indicating an important potential for prevention.
Ribotyping of 585 CDI strains from 103 different hospitals in 2013 identified 133 different ribotypes, 72 of them isolated only once, 60 never identified before in Belgium. This illustrates the multiplicity of sources of transmission. The ribotypes most frequently isolated were ribotypes O14 (8% of total strains typed) and 020 (7%). The proportion of hospitals with the hypervirulent ribotype 027 decreased from 34% in 2009 to 15% in 2013. A decline in the prevalence of the ribotype 027 has been reported as well in the United Kingdom, and the Netherlands.
International comparisons indicate that Belgium has incidence rates of CDI in the mid-range of other European countries and lower than that in the United States. There are some indications that incidence of CDI is again rising in Europe, as it is in Belgium.

%I WIV-ISP %C Brussels %V %P 41 %8 0/7/2014 %@ 2034-4562 %G eng %M NA %1 31466 %2 2014-023 %0 Journal Article %J N O S O - i n f o %D 2014 %T Geïmporteerde carbapenemase-producerende Enterobacteriaceae: de Belgische context %A Jans,B. %A T-D. D. Huang %A Bauraing,C. %A Berhin,C. %A P Bogaerts %A Deplano,A. %A O. Denis %A Boudewijn Catry %A Y. Glupczynski %K 2012 %K AAN %K België %K Belgische %K carbapenemase %K Context %K CPE %K de %K EN %K Enterobacteriaceae %K Hand %K IS %K land %K MEN %K risico %K Surveillance %K Type %X Aan de hand van de actieve CPE-surveillance opgestart in België in 2012, krijgt men enig idee in verband met het voorkomen van aan het buitenland gerelateerde CPE-gevallen in België. Dit artikel toont de beperkingen van de surveillance (36% ontbrekende gegevens) en illustreert eveneens andere potentiële bronnen van CPE-import, al dan niet gerelateerd aan gezondheidszorgcontacten in het buitenland.Omwille van de mondialisering van de problematiek van multiresistente bacteriën en van CPE in het bijzonder is het aangewezen om patiënten die gezondheidszorgen toegediend kregen in het buitenland te beschouwen als patiënten met een verhoogd risico, dit ongeacht het land hoewel het risico en het type CPE tussen de verschillende geografische zones kunnen verschillen.Verder dient men alert te blijven in situaties waarbij de hierboven beschreven bronnen van CPE-import aanwezig kunnen zijn. %B N O S O - i n f o %V XIX %8 1/12/2014 %G eng %N Nummer 2 %1 31593 %0 Report %D 2014 %T Impact van het gebruik van een vloeibare zeep besmet met Burkholderia cepacia in Belgische ziekenhuizen: studieresultaten 2014 %A Jans,B. %A Denis Piérard %A Vrindts,E. %A Vandamme,P. %A Boudewijn Catry %A Christiaens,G. %A Cox,P. %A A. De Bel %A Descy,J. %A Echahidi,F. %A D. Famerée %A Melin,P. %A Peeters,C. %A Carole Schirvel %A Jean-Marie Tremerie %A Verbelen,V. %K Antimicrobial resistance %K Belgische %K gebruik %K hospital %K Impact %K ziekenhuizen %I WIV-ISP %C Brussels %P 10 %8 0/0/2014 %@ D/2014/2505/25 %G eng %1 31480 %2 2014-016 %0 Journal Article %J Vet J %D 2014 %T Macrolides and lincosamides in cattle and pigs: use and development of antimicrobial resistance. %A Pyörälä, Satu %A Baptiste, Keith Edward %A Boudewijn Catry %A van Duijkeren, Engeline %A Greko, Christina %A Moreno, Miguel A %A Pomba, M Constança Matias Ferreira %A Rantala, Merja %A Ruzauskas, Modestas %A Sanders, Pascal %A Threlfall, E John %A Torren-Edo, Jordi %A Törneke, Karolina %K Animals %K Anti-Bacterial Agents %K bacteria %K Cattle %K Cattle Diseases %K Drug Resistance, Bacterial %K Europe %K Lincosamides %K Macrolides %K Swine %K Swine Diseases %X

Macrolides and lincosamides are important antibacterials for the treatment of many common infections in cattle and pigs. Products for in-feed medication with these compounds in combination with other antimicrobials are commonly used in Europe. Most recently approved injectable macrolides have very long elimination half-lives in both pigs and cattle, which allows once-only dosing regimens. Both in-feed medication and use of long-acting injections result in low concentrations of the active substance for prolonged periods, which causes concerns related to development of antimicrobial resistance. Acquired resistance to macrolides and lincosamides among food animal pathogens, including some zoonotic bacteria, has now emerged. A comparison of studies on the prevalence of resistance is difficult, since for many micro-organisms no agreed standards for susceptibility testing are available. With animal pathogens, the most dramatic increase in resistance has been seen in the genus Brachyspira. Resistance towards macrolides and lincosamides has also been detected in staphylococci isolated from pigs and streptococci from cattle. This article reviews the use of macrolides and lincosamides in cattle and pigs, as well as the development of resistance in target and some zoonotic pathogens. The focus of the review is on European conditions.

%B Vet J %V 200 %P 230-9 %8 2014 May %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/24685099?dopt=Abstract %R 10.1016/j.tvjl.2014.02.028 %0 Report %D 2014 %T Microbiologische- en epidemiologische survaillance van carbapenemase producerende Enterobacteriaceae in België: januari 2012 - juni 2014. %A Jans,B. %A Boudewijn Catry %A Y. Glupczynski %K 2012 %K België %K carbapenemase %K de %K EN %K Enterobacteriaceae %K rapport %I WIV-ISP %C Brussels %P 19 %8 1/12/2014 %G eng %1 31590 %0 Journal Article %J J Antimicrob Chemother %D 2014 %T Pleuromutilins: use in food-producing animals in the European Union, development of resistance and impact on human and animal health. %A van Duijkeren, Engeline %A Greko, Christina %A Pringle, Märit %A Baptiste, Keith Edward %A Boudewijn Catry %A Jukes, Helen %A Moreno, Miguel A %A Pomba, M Constança Matias Ferreira %A Pyörälä, Satu %A Rantala, Merja %A Ruzauskas, Modestas %A Sanders, Pascal %A Teale, Christopher %A Threlfall, E John %A Torren-Edo, Jordi %A Törneke, Karolina %K Animals %K Anti-Bacterial Agents %K Brachyspira hyodysenteriae %K Diterpenes %K Drug Resistance, Bacterial %K European Union %K Humans %K Microbial Sensitivity Tests %K Mycoplasma Infections %K Poultry %K Poultry Diseases %K Rabbits %K Swine %K Swine Diseases %X

Pleuromutilins (tiamulin and valnemulin) are antimicrobial agents that are used mainly in veterinary medicine, especially for swine and to a lesser extent for poultry and rabbits. In pigs, tiamulin and valnemulin are used to treat swine dysentery, spirochaete-associated diarrhoea, porcine proliferative enteropathy, enzootic pneumonia and other infections where Mycoplasma is involved. There are concerns about the reported increases in the MICs of tiamulin and valnemulin for porcine Brachyspira hyodysenteriae isolates from different European countries, as only a limited number of antimicrobials are available for the treatment of swine dysentery where resistance to these antimicrobials is already common and widespread. The loss of pleuromutilins as effective tools to treat swine dysentery because of further increases in resistance or as a consequence of restrictions would present a considerable threat to pig health, welfare and productivity. In humans, only one product containing pleuromutilins (retapamulin) is authorized currently for topical use; however, products for oral and intravenous administration to humans with serious multidrug-resistant skin infections and respiratory infections, including those caused by methicillin-resistant Staphylococcus aureus (MRSA), are being developed. The objective of this review is to summarize the current knowledge on the usage of pleuromutilins, resistance development and the potential impact of this resistance on animal and human health.

%B J Antimicrob Chemother %V 69 %P 2022-31 %8 2014 Aug %G eng %N 8 %1 http://www.ncbi.nlm.nih.gov/pubmed/24793902?dopt=Abstract %R 10.1093/jac/dku123 %0 Journal Article %J PLoS.One. %D 2014 %T Risk factors for methicillin resistant Staphylococcus aureus: a multi-laboratory study %A Boudewijn Catry %A Katrien Latour %A Jans, B %A Vandendriessche,S. %A Preal, R %A Karl Mertens %A O. Denis %K Antimicrobial resistance %K Staphylococcus aureus %X

BACKGROUND: The present study aimed to investigate the dose response relationship between the prescriptions of antimicrobial agents and infection/colonization with methicillin resistant Staphylococcus aureus (MRSA) taking additional factors like stay in a health care facility into account. METHODS: Multi-centre retrospective study on a cohort of patients that underwent microbiological diagnostics in Belgium during 2005. The bacteriological results retrieved from 17 voluntary participating clinical laboratories were coupled with the individual antimicrobial consumption patterns (July 2004-December 2005) and other variables as provided by pooled data of health insurance funds. Multivariate analysis was used to identify risk factors for MRSA colonization/infection. RESULTS: A total of 6844 patients of which 17.5% died in the year 2005, were included in a logistic regression model. More than 97% of MRSA was associated with infection (clinical samples), and only a minority with screening/colonization (1.59%). Factors (95% CI) significantly (p

%B PLoS.One. %V 9 %P e89579 %8 14/4/2014 %G eng %N 2 %1

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%& e89579 %R http://dx.doi.org/10.1371/journal.pone.0089579 %0 Report %D 2014 %T Surveillance microbiologique et épidémiologique des Entérobactéries productrices de carbapénémases en Belgique: janvier 2012- juin 2014 %A Jans,B. %A Boudewijn Catry %A Y. Glupczynski %K 2012 %K Antimicrobial resistance %K Belgique %K CPE %K de %K EN %K ET %K rapport %K Surveillance %I WIV-ISP %C Brussels %P 19 %8 1/12/2014 %G eng %1 31589 %0 Report %D 2013 %T Alternative sampling methods for collection of urine specimens in older adults %A Katrien Latour %A A. Plüddemann %A Thompson,M. %A Boudewijn Catry %A Price,C.P. %A Heneghan,C. %A F.J. Buntinx %K Adult %K adults %K Aged %K alternative %K method %K methods %K older %K older adults %K sampling %K urinary tract infection %K urine %K urine specimen collection %I Monitoring & Diagnostic Office %C Oxford %V Horizon Scan Report 0028 %P 7 %8 3/1/2013 %G eng %1 30935 %2 Horizon Scan Report 0028 %& 1 %0 Generic %D 2013 %T Antibiograms of consecutive urinary tract samples in elderly %A Katrien Latour %A Jans, B %A Coenen, S %A Preal, R %A Boudewijn Catry %K Antimicrobial resistance %K older adults %K Urinary Tract Infections %B International Conference on Prevention & Infection Control %I International Consortium for Prevention & Infection Control %C Geneva, Switzerland %8 27/6/2013 %G eng %N International Consortium for Prevention & Infection Control %1

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%2 26/06/2013 %0 Journal Article %J Int.J.Environ.Res.Public Health %D 2013 %T Antimicrobial resistance in the food chain: a review34030 %A Verraes,C. %A Van Boxstael,S %A Van Meervenne,E. %A E. Van Coillie %A Butaye,P. %A Boudewijn Catry %A De Schaetzen,M.A. %A Van Huffel,X. %A Hein Imberechts %A Katelijne Dierick %A Daube,G. %A Saegerman,C. %A De Block,J. %A Dewulf,J. %A Herman,L. %K 0 %K a %K Agent %K Agents %K Agriculture %K an %K Animals %K Anti-Bacterial Agents %K Antibiotic %K antibiotics %K Antimicrobial %K Antimicrobial resistance %K article %K AS %K bacteria %K Bacteriophages %K Belgium %K Brussels %K Cell %K cells %K commensal %K conditions %K Control %K culture %K Drug Resistance,Bacterial %K electronic %K food %K Food Chain %K Food Handling %K Food Microbiology %K gene %K Genes %K health %K Human %K Humans %K im %K Increase %K IS %K journal %K microorganism %K microorganisms %K ON %K pathogen %K pathogenic %K POLICIES %K POLICY %K present %K preservation %K Probiotics %K PROCESSES %K production %K PRODUCTS %K public %K public health %K Public-health %K resistance %K REVIEW %K risk %K SAFETY %K SB - IM %K SELECTED %K strain %K therapeutic use %K Traits %K Transmission %K treatment %K use %X Antimicrobial resistant zoonotic pathogens present on food constitute a direct risk to public health. Antimicrobial resistance genes in commensal or pathogenic strains form an indirect risk to public health, as they increase the gene pool from which pathogenic bacteria can pick up resistance traits. Food can be contaminated with antimicrobial resistant bacteria and/or antimicrobial resistance genes in several ways. A first way is the presence of antibiotic resistant bacteria on food selected by the use of antibiotics during agricultural production. A second route is the possible presence of resistance genes in bacteria that are intentionally added during the processing of food (starter cultures, probiotics, bioconserving microorganisms and bacteriophages). A last way is through cross-contamination with antimicrobial resistant bacteria during food processing. Raw food products can be consumed without having undergone prior processing or preservation and therefore hold a substantial risk for transfer of antimicrobial resistance to humans, as the eventually present resistant bacteria are not killed. As a consequence, transfer of antimicrobial resistance genes between bacteria after ingestion by humans may occur. Under minimal processing or preservation treatment conditions, sublethally damaged or stressed cells can be maintained in the food, inducing antimicrobial resistance build-up and enhancing the risk of resistance transfer. Food processes that kill bacteria in food products, decrease the risk of transmission of antimicrobial resistance %B Int.J.Environ.Res.Public Health %V 10 %P 2643 - 2669 %8 0/7/2013 %G eng %N 7 %1 34030 %& 2643 %R http://dx.doi.org/10.3390/ijerph10072643 %0 Journal Article %J Epidemiol Infect %D 2013 %T Antimicrobial resistance to benzylpenicillin in invasive pneumococcal disease in Belgium, 2003-2010: the effect of altering clinical breakpoints. %A Goossens, M C %A Boudewijn Catry %A Verhaegen, J %K Anti-Bacterial Agents %K Bacteremia %K Belgium %K Drug Resistance, Bacterial %K Epidemiological Monitoring %K Humans %K Microbial Sensitivity Tests %K Penicillin G %K Pneumococcal Infections %K Practice Guidelines as Topic %K Streptococcus pneumoniae %X

The Belgian data (2003-2010) for the European Antimicrobial Resistance Surveillance Network (EARS-Net) showed a significant decreasing trend in the proportion of penicillin non-susceptible Streptococcus pneumoniae (9·4% to <1%) from blood and CSF isolates. We found that 75% of this decrease was explained by a change in Clinical and Laboratory Standards Institute (CLSI) breakpoints as the trend disappeared if only the new breakpoints were applied. Applying only European Committee on Antimicrobial Susceptibility Testing (EUCAST) breakpoints also resulted in a relatively stable proportion of penicillin non-susceptibility (average 5%), but this proportion was 7-13 times higher than with the new CLSI breakpoints. When the new CLSI breakpoints alone are used, fewer than 1% of bacteraemia isolates were penicillin non-susceptible during the entire period, but the proportion of non-susceptible meningitis isolates rose from 6·3% in 2003 to 15·9% between 2003 and 2010. Changing breakpoints should lead to retrospective analysis of historical data to minimize wrongly interpreting resistance trends.

%B Epidemiol Infect %V 141 %P 490-5 %8 2013 Mar %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/22677465?dopt=Abstract %R 10.1017/S0950268812001057 %0 Generic %D 2013 %T Carbapenemase-producing Enterobacteriaceae in Belgium: surveillance data January 2012 - June 2013 %A Jans,B. %A T-D. D. Huang %A P Bogaerts %A Boudewijn Catry %A Y. Glupczynski %K 2012 %K Agent %K Agents %K Antimicrobial %K Belgium %K conference %K CPE %K data %K Enterobacteriaceae %K ON %K Surveillance %B Interscience Conference on Antimicrobial Agents and Chemotherapy %I NA %C NA %8 13/9/2013 %G eng %N ICAAC %1 31038 %2 13/09/2013 %0 Generic %D 2013 %T CPE in België: verleden, heden en toekomst %A Jans,B. %A Y. Glupczynski %A Boudewijn Catry %K België %K CPE %K EN %B Ziekenhuishygiëne Sint Nikolaasziekenhuis %I NA %C NA %8 5/10/2013 %G eng %N Dienst Ziekenhuishygiëne,Sint Nikolaasziekenhuis %1 37990 %2 05/10/2013 %0 Generic %D 2013 %T Determinants and prevalence of methicillin-resistant Staphylococcus aureus (MRSA) carriage among residents in Belgian nursing homes: comparison of two national prevalence surveys: 2005 versus 2011 %A Jans, B %A O. Denis %A Schoevaerdts, D %A Katrien Latour %A Boudewijn Catry %A Nonhoff, C %A Deplano, A %A Huang, T.D. %A Behrin, P %A Bogaerts, P %A Glupczynski, Y %K Antimicrobial resistance %K nursing homes %B 23rd European Congress of Clinical Microbiology and Infectious Disease %I European Society of Clinical Microbiology and Infectious Diseases %C Berlin, Germany %8 29/4/2013 %G eng %N European Society of Clinical Microbiology and Infectious Diseases %1

30963

%2 29/04/2013 %0 Journal Article %J Family Medicine and Community Health %D 2013 %T Diagnostic technology: alternative sampling methods for collection of urine specimens in older adults %A Katrien Latour %A Plüddemann, A %A Thompson, M %A Boudewijn Catry %A Price, CP %A Heneghan, C %A Buntinx, F %K older adults %K Urinary Tract Infections %B Family Medicine and Community Health %V 1 %8 Jan-06-2013 %G eng %N 2 %R 10.15212/FMCH.2013.0207 %0 Journal Article %J PLoS One %D 2013 %T Epidemiology of multidrug-resistant microorganisms among nursing home residents in Belgium. %A Beatrice Jans %A Schoevaerdts, Didier %A Huang, Te-Din %A Berhin, Catherine %A Katrien Latour %A Bogaerts, Pierre %A Nonhoff, Claire %A Denis, O %A Boudewijn Catry %A Glupczynski, Youri %K Adult %K Aged %K Aged, 80 and over %K bacteria %K Bacterial Physiological Phenomena %K Belgium %K Drug Resistance, Bacterial %K Drug Resistance, Multiple %K Female %K Humans %K Male %K middle aged %K nursing homes %K Risk Factors %K Surveys and Questionnaires %X

OBJECTIVES: A national survey was conducted to determine the prevalence and risk factors of methicillin-resistant Staphylococcus aureus (MRSA), extended-spectrum β-lactamases-producing Enterobacteriaceae (ESBLE) and vancomycin-resistant enterococci (VRE) among nursing home residents in Belgium.

METHODS: A random stratified, national prevalence survey was conducted in nursing home residents who were screened for carriage of ESBLE, MRSA and VRE by multisite enriched culture. Characteristics of nursing homes and residents were collected by a questionnaire survey and were analysed by multilevel logistic regression analysis.

RESULTS: Of 2791 screened residents in 60 participating nursing home, the weighted prevalence of ESBLE and MRSA carriage were 6.2% (range: 0 to 20%) and 12.2% (range: 0 to 36%), respectively. No cases of VRE were found. No relationship was found between ESBLE and MRSA prevalence rates within nursing homes and the rate of co-colonization was very low (0.8%). Geographical variations in prevalence of MRSA and ESBLE and in distribution of ESBL types in nursing home residents paralleled that of acute hospitals. Risk factors of ESBLE carriage included previously known ESBLE carriage, male gender, a low level of mobility and previous antibiotic exposure. Risk factors for MRSA colonization were: previously known MRSA carriage, skin lesions, a low functional status and antacid use.

CONCLUSIONS: A low prevalence of ESBLE carriage was found in nursing home residents in Belgium. The prevalence of MRSA carriage decreased substantially in comparison to a similar survey conducted in 2005. A low functional status appeared as a common factor for ESBLE and MRSA carriage. Previous exposure to antibiotics was a strong predictor of ESBLE colonization while increased clustering of MRSA carriage suggested the importance of cross-transmission within nursing homes for this organism. These results emphasize the need for global coordination of the surveillance of MDRO within and between nursing homes and hospitals.

%B PLoS One %V 8 %P e64908 %8 2013 %G eng %N 5 %1 http://www.ncbi.nlm.nih.gov/pubmed/23738011?dopt=Abstract %& e64908 %R 10.1371/journal.pone.0064908 %0 Report %D 2013 %T Etude nationale de prévalence du portage de germes résistants aux antibiotiques dans 60 maisons de repos et de soins en Belgique en 2011: Rapport final – octobre 2012 %A Beatrice Jans %A Katrien Latour %A Boudewijn Catry %A Schoevaerdts, D %A Huang, T.D. %A Berhin,C. %A Bogaerts, P %A Glupczynski, Y %A Nonhoff,C. %A Deplano,A. %A Denis, O %K 2011 %K antibiotiques %K Belgique %K étude %K germes résistants %K maisons de repos et de soins %K portage %K prevalence %X

NA

%I WIV-ISP %C Brussels, Belgium %P 52 %8 2013 %G eng %M D/2013/2505/05 %0 Journal Article %J Reprod.Domest.Anim %D 2013 %T Hydrallantois in the mare--a report of five cases %A Govaere,J.L. %A C. De Schauwer %A Hoogewijs,M.K. %A Chiers,K. %A Lefere,L. %A Boudewijn Catry %A Roels,K. %A M. van Heerden %A Broeckx,S. %A A. de Kruif %K a %K Abdomen %K acute %K ALL %K an %K Appetite %K article %K AS %K Belgium %K Breeding %K Case %K Clinical %K data %K electronic %K Faculty %K Genetic %K Help %K im %K INFORMATION %K IS %K IT %K journal %K Medicine %K ON %K PREGNANT %K Prognosis %K report %K reports %K reproduction %K SB - IM %K series %K time %K treatment %K Universities %K university %K veterinary %K Veterinary Medicine %X Hydrallantois in the mare is a very rare condition, and clinical reports help to gather information to elucidate its pathogenesis, treatment options and prognosis. Five different cases of hydrallantois in the mare are reported in this article, all with the involvement of placentitis. The five mares were presented because of acute distention of the abdomen, dyspnoea, stiff gait and a lack of appetite. After a gradual release of the excessive amount of allantoic fluid, an abortion was induced in all five mares. The foals were either born dead or euthanized. The mares recovered quickly. One mare conceived within the same season, one remained barren despite several cycles of natural breeding, and no data were available on the other three mares. In this series, the condition is reported for the first time in two Shetland ponies, both pregnant with foals sharing a close genetic background. In both cases, the condition led to hyperlipidemia. The condition as it occurs in nulliparous mares is also discussed. Finally, the possible involvement of placentitis in the pathogenesis is emphasized %B Reprod.Domest.Anim %V 48 %P e1 - e6 %8 0/2/2013 %G eng %N 1 %1 31014 %& e1 %R http://dx.doi.org/10.1111/j.1439-0531.2012.02013.x %0 Generic %D 2013 %T Improving usefulness of data collection systems at hospital level: The example of Belgian national surveillance of hospital acquired bloodstream infections %A N Hammami %A Boudewijn Catry %A Sylvanus Fonguh %A A Ingenbleek %A Marie-Laurence Lambert %K at %K Belgian %K Bloodstream infection %K Bloodstream infections %K care %K data %K Data collection %K health %K health care %K HEALTH-CARE %K hospital %K INFECTION %K infections %K LEVEL %K london %K national %K NH %K ON %K poster %K PRESENTATION %K Quality %K SAFETY %K Surveillance %K System %B IHI and BMJ Forum on quality and Safety in Health care %I NA %C NA %8 1/4/2013 %G eng %N Institute for Healthcare Improvement, BMJ %1 35270 %2 16/04/2013 %0 Journal Article %J J Hosp Infect %D 2013 %T Infections acquired in intensive care units: results of national surveillance in Belgium, 1997-2010. %A Karl Mertens %A Morales, I %A Boudewijn Catry %K Belgium %K Cross Infection %K Humans %K incidence %K intensive care units %K Prospective Studies %X

BACKGROUND AND AIM: To describe the methodology and output of the Belgian surveillance for infections acquired in intensive care units (ICUs) between 1997 and 2010.

METHODS: Since 1997, ICUs in acute care hospitals in Belgium have been encouraged by federal law to participate in a national multi-centre prospective observational surveillance programme. A protocol and software tool for data collection was developed, and the case definitions and methodology follow those of the European Centre for Disease Prevention and Control.

FINDINGS: For 2010, 18 hospitals provided data on 59 observation quarters, 6478 ICU patients and 52,593 ICU patient-days. The mean incidence rates of ICU-acquired pneumonia and intubation-associated pneumonia were 13 per 1000 patient-days and 12 per 1000 intubation-days, respectively. The mean incidence rates of ICU-acquired bloodstream infections, central vascular catheter (CVC)-associated bloodstream infections and CVC-associated primary bloodstream infections were 3.2 per 1000 patient-days, 2.6 per 1000 catheter-days and 2.3 per 1000 catheter-days, respectively. Between 1997 and 2010, stable trends in ICU-acquired pneumonia and bloodstream infections were observed, together with decreasing trends for intubation-associated pneumonia and CVC-associated bloodstream infections, and a stable trend for CVC-associated primary bloodstream infections.

CONCLUSIONS: In Belgium, national surveillance of ICU-acquired infections allows acute care hospitals to track the incidence of infections at local level, enabling comparison with national and European reference data. Between 1997 and 2010, the incidence of ICU-acquired infections increased and the incidence of device-associated infections decreased.

%B J Hosp Infect %V 84 %P 120-5 %8 2013 Jun %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/23639819?dopt=Abstract %& 120 %R 10.1016/j.jhin.2013.02.017 %0 Journal Article %J J.Microbiol.Methods %D 2013 %T Optimization of Campylobacter growth conditions for further identification by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS)3 %A Martiny,D. %A Visscher,A. %A Boudewijn Catry %A Chatellier,S. %A Vandenberg,O. %K article %K Belgium %K Brussels %K Campylobacter %K conditions %K data %K electronic %K growth %K hospital %K identification %K Institute %K IS %K journal %K MALDI-TOF %K MALDI-TOF MS %K Mass %K Mass Spectrometry %K MEDIA %K medical %K microbiology %K MS %K ON %K result %K results %K Temperature %K time of flight %K Universities %K university %K university hospital %X Growth conditions - including growth medium and incubation temperature - may influence the identification of Campylobacter by MALDI-TOF MS. For each bacterial species, medical microbiologists should be aware of such potential influences on spectral data before analyzing and interpreting MALDI-TOF MS results %B J.Microbiol.Methods %V 94 %P 221 - 223 %8 26/6/2013 %G eng %N 3 %1 31034 %& 221 %R http://dx.doi.org/10.1016/j.mimet.2013.06.018 %0 Generic %D 2013 %T Prévalence des infections associées aux soins, de la consommation d'antibiotiques et du portage de bactéries résistantes en Maison de Repos et de Soins en Belgique %A Jans,B. %A Katrien Latour %A Boudewijn Catry %E Plateforme régionale en hygiène hospitalière du Hainaut %K antimicrobial use %K Belgique %K de %K EN %K ET %K healthcare-associated infections %K INFECTION %K infections %K maison de repo %K maison de repos %K nursing homes %B Plateforme régionale en hygiène hospitalière du Hainaut %8 26/3/2013 %G eng %N Plateforme régionale en hygiène hospitalière du Hainaut %1 35275 %2 26/03/2013 %0 Journal Article %J J Antimicrob Chemother %D 2013 %T Prevalence, risk factors and genetic diversity of methicillin-resistant Staphylococcus aureus carried by humans and animals across livestock production sectors. %A Vandendriessche, Stien %A Vanderhaeghen, Wannes %A Soares, Filomena Valente %A Hallin, Marie %A Boudewijn Catry %A Hermans, Katleen %A Butaye, Patrick %A Haesebrouck, Freddy %A Struelens, Marc J %A Denis, O %K Animals %K Belgium %K Carrier State %K Genetic Variation %K Genotype %K Humans %K Livestock %K Methicillin-Resistant Staphylococcus aureus %K Microbial Sensitivity Tests %K prevalence %K Risk Factors %K Staphylococcal Infections %K Virulence Factors %X

OBJECTIVES: This study aimed to assess the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in animals and humans on veal, dairy, beef and broiler farms and to compare the risk for human MRSA carriage with that of strictly horticulture farmers. The genetic background, resistance phenotypes and genotypes and toxin gene content of the isolated MRSA strains were compared with MRSA collected on MRSA clonal complex (CC)398-positive pig farms.

METHODS: MRSA carriage isolates were genotyped (spa, SCCmec and multilocus sequence typing), resistance to 16 antimicrobials was determined and resistance and toxin genes were detected.

RESULTS: MRSA carriage rates were higher (P<0.01) on veal farms (calves, 64%; farmers, 72%) compared with on dairy (cows, 1%), beef (cows, 5%; farmers, 11%), broiler (pooled broths, 5%; farmers, 3%) and horticulture (farmers, 3%) farms. The intensity of animal contact was identified as a risk factor for human MRSA carriage. The vast majority of MRSA (n=344), including those from pigs, were CC398 (98%). SCCmec V(5C2), V(5C2&5)c, IV(2B) and IV(2B&5) predominated. MRSA CC130 and CC599 carrying mecC were detected in beef and dairy cattle. MRSA from veal calves were significantly more resistant than MRSA from pigs (P<0.01). A few isolates, including mecC-carrying MRSA, harboured pyrogenic superantigen toxins. Human- and animal-derived MRSA from individual farms showed similar characteristics.

CONCLUSIONS: This systematic cross-sector survey revealed a high prevalence of multiresistant livestock-associated MRSA on Belgian veal calf farms as compared with other farm types. MRSA harbouring mecC was detected at a low frequency in beef and dairy cows, but not in humans.

%B J Antimicrob Chemother %V 68 %P 1510-6 %8 2013 Jul %G eng %N 7 %1 http://www.ncbi.nlm.nih.gov/pubmed/23429641?dopt=Abstract %& 1510 %R 10.1093/jac/dkt047 %0 Report %D 2013 %T Surveillanceprogramma van septicemieën in ziekenhuizen in België - Gegevens 2000-2011 %A N Hammami %A Marie-Laurence Lambert %A Boudewijn Catry %K België %K de %K EN %K hospital %K nosocomial infection %K programma %K septicemie %K Surveillance %K ziekenhuizen %X

Septicemia acquired at the hospital are frequent, serious and potentially preventable, in particular for the septicemia associated to invasive devices. For this reason, Belgium organized a national septicemia surveillance (SEP) since 1992.
The number of hospitals participating for a required minimum of 3 months per year to the SEP surveillance is variable over the period 2000-2011 with annually about 70 to 80 participating hospitals. In the transition year 2011 (review of the protocol), a decrease in the number of participating hospitals (52) was observed. During this period, a total of 49.286 SEP episodes acquired at the hospital was registered, with an incidence of 6,5 SEP/1.000 admissions and 8,4/10.000 patient-days (pd).
The incidence of SEP acquired at the intensive care unit (ICU) was 19,1 SEP/1.000 ICU admissions and 44,5/10.000 pd at ICU. The variability in the number of participating hospitals over the observation period makes the interpretation of the annual trends at the national level difficult.
From these 49.286 episodes, 12.697 (26%) were admitted in an internal medicine service and 10.226 (21%) at ICU. A central venous catheter (CVC) was considered as the origin of infection in 11.665 SEP (25%) (31% of SEP at ICU). However, the fact that a high number of data is missing suggests that the real proportion of CVC associated septicemia may even be higher. A total of 41.936 (41%) of hospital acquired SEP have been documented as being secondary to an infection at another site; from these 6.601 (14%) were attributed to an urinary tract infection and 4.656 (10%) to a pulmonary infection (respectively 6% and 20% at ICU).
Pathogene microorganisms were involved in 41.936 (85%) of hospital acquired SEP. The remaining 7.350 (15%) were caused exclusively by skincontaminants. The most common microorganisms were E. coli (17%), S. aureus (12%) and types of Staphylococcus coagulase-negative (11%). The specific incidence of hospital acquired SEP with E. coli increased from 1,2/10.000 pd in 2000 to 1,7/10.000 pd in 2011. The specific incidence of hospital acquired SEP caused by Pseudomonas aeruginosae and Klebsiella pneumoniae remained stable.
These incidence data are higher than those reported by the surveillances (hospitalwide) from other countries. The results highlight the importance of the strengthening of the precautions against hospital acquired SEP and in particular SEP associated with invasive devices and SEP acquired at ICU.

%I WIV-ISP %C Brussels, Belgium %P 43 %8 1/4/2013 %G eng %M D/2013/2505/11 %1 35271 %0 Journal Article %J Prev.Vet.Med. %D 2012 %T Antimicrobial use in Belgian broiler production %A Persoons,D. %A Dewulf,J. %A Smet,A. %A Herman,L. %A Heyndrickx,M. %A Martel,A. %A Boudewijn Catry %A Butaye,P. %A Haesebrouck,F. %K 0 %K 2007 %K 2008 %K administration & dosage %K Agent %K Agents %K Amoxicillin %K an %K Animal %K Animal Husbandry %K Animals %K Anti-Infective Agents %K Antimicrobial %K antimicrobial use %K Antimicrobials %K article %K AS %K bacteria %K Belgian %K Belgium %K Chickens %K Combination %K commensal %K CONSUMPTION %K doses %K DRUG %K Drug Combinations %K Drug Resistance,Microbial %K electronic %K epidemiology %K Face %K Faculty %K farms %K health %K im %K incidence %K IS %K IT %K journal %K LEVEL %K levels %K Medicine %K methods %K Obstetrics %K ON %K pathogenic %K Poultry Diseases %K prevention & control %K production %K Quantification %K Ratio %K reproduction %K Research %K Research Support %K resistance %K SB - IM %K Sulfadoxine %K therapeutic use %K treatment %K Trimethoprim %K Tylosin %K Universities %K university %K use %K veterinary %X The use of antimicrobials in production animals has become a worldwide concern in the face of rising resistance levels in commensal, pathogenic and zoonotic bacteria. In the years 2007 and 2008 antimicrobial consumption records were collected during two non consecutive production cycles in 32 randomly selected Belgian broiler farms. Antimicrobials were used in 48 of the 64 monitored production cycles, 7 farms did not use any antimicrobials in both production cycles, 2 farms only administered antimicrobials in one of the two production cycles, the other 23 farms applied antimicrobial treatment in both production cycles. For the quantification of antimicrobial drug use, the treatment incidences (TI) based on the defined daily doses (the dose as it should be applied: DDD) and used daily doses (the actual dose applied: UDD) were calculated. A mean antimicrobial treatment incidence per 1000 animals of 131.8 (standard deviation 126.8) animals treated daily with one DDD and 121.4 (SD 106.7) animals treated daily with one UDD was found. The most frequently used compounds were amoxicillin, tylosin and trimethoprim-sulphonamide with a mean TI(UDD) of 37.9, 34.8, and 21.7, respectively. The ratio of the UDD/DDD gives an estimate on correctness of dosing. Tylosin was underdosed in most of the administrations whereas amoxicillin and trimethoprim-sulphonamide were slightly overdosed in the average flock %B Prev.Vet.Med. %V 105 %P 320 - 325 %8 1/8/2012 %G eng %N 4 %1 35300 %& 320 %R http://dx.doi.org/10.1016/j.prevetmed.2012.02.020 %0 Journal Article %J Food research international %D 2012 %T Comparison of antimicrobial resistance patterns and phage types of Salmonella Typhimurium isolated from pigs, pork and humans in Belgium between 2001 and 200631075 %A Van Boxstael,S %A Katelijne Dierick %A Van Huffel,X. %A Uyttendaele,M. %A Dirk Berkvens %A Herman,L. %A Sophie Bertrand %A C. Wildemauwe %A Boudewijn Catry %A Butaye,P. %A Hein Imberechts %K 2001 %K 2006 %K a %K acid %K Agreement %K Ampicillin %K Antimicrobial %K Antimicrobial resistance %K Antimicrobials %K AS %K Belgium %K cephalosporin %K Cephalosporins %K Chloramphenicol %K Combination %K Common %K Comparison %K CONSUMPTION %K Countries %K Fluoroquinolones %K Group %K hazard %K health %K Human %K Humans %K Hypothesis %K incidence %K INFECTION %K infections %K IS %K Less %K n %K Nalidixic Acid %K observed %K ORIGIN %K pathogen %K Pathways %K pattern %K PATTERNS %K period %K Phage type %K Pig %K Pigs %K Pork %K resistance %K S %K Salmonella %K Salmonella typhimurium %K Spread %K Streptomycin %K study %K Tetracycline %K Type %X Infections with non-typhoid %B Food research international %V 45 %P 913 - 918 %8 0/0/2012 %G eng %N 2 %1 31075 %& 913 %R http://dx.doi.org/10.1016/j.foodres.2011.05.025 %0 Generic %D 2012 %T Determinanten van dragerschap van multiresistente kiemen in WZC: dragerschap van MRSA. %A Jans, B %A Katrien Latour %A Boudewijn Catry %A Schoevaerdts, D %A Huang, T.D. %A Berhin, C %A Bogaerts, P %A Glupczynski, Y %A Nonhoff, C %A Deplano, A %A Hallin, M %A O. Denis %K Antimicrobial resistance %K nursing homes %B BICS Symposium %I Belgian Infection Control Society %C Brussels, Belgium %8 17/11/2012 %G eng %N Belgian Infection Control Society %1

30897

%2 17/11/2012 %0 Generic %D 2012 %T Déterminants du portage de Staphylocoque doré résistant à la méthicilline (MRSA) en maison de repos et de soins %A Jans,B. %A Katrien Latour %A Boudewijn Catry %K Belgian %K Control %K de %K EN %K ET %K INFECTION %K Infection Control %K maison de repo %K maison de repos %K Methicillin-Resistant Staphylococcus aureus %K MRSA %K nursing homes %K Risk Factors %K Societies %K Society %K symposium %B Symposium Belgian Infection Control Society %I NA %C NA %8 0/0/2012 %G eng %N Belgian infection control society %1 30973 %2 17/10/2012 %0 Generic %D 2012 %T Etude de prévalence et des facteurs de risque de colonisation par des bactéries multi-résistantes chez des sujets âgés résidant en MRS en Belgique en 2011 %A Jans, B %A Katrien Latour %A Boudewijn Catry %K Antimicrobial resistance %K Belgique %K de %K EN %K ET %K nursing homes %K older adults %K PAR %K symposium %B Symposium BAPCOC %I Belgian Antibiotic Policy Coordination Committee %C Brussels, Belgium %8 29/10/2012 %G eng %N Belgian Antibiotic Policy Coordination Committee %1

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%2 29/10/2012 %0 Journal Article %J Euro Surveill %D 2012 %T The European Centre for Disease Prevention and Control (ECDC) pilot point prevalence survey of healthcare-associated infections and antimicrobial use. %A Zarb, P %A Coignard, B %A Griskeviciene, J %A Muller, A %A Vankerckhoven, V %A Weist, K %A Goossens, Mm %A Vaerenberg, S %A Hopkins, S %A Boudewijn Catry %A Monnet, Dl %A Goossens, H %A Suetens, C %K ADOLESCENT %K Adult %K Aged %K Aged, 80 and over %K Anti-Infective Agents %K Child %K Child, Preschool %K Cross Infection %K Drug Utilization Review %K Europe %K Feasibility Studies %K Female %K Government Agencies %K health surveys %K hospitals %K Humans %K Infant %K Infant, Newborn %K Infection Control %K Logistic Models %K Male %K middle aged %K Population Surveillance %K prevalence %K Risk Factors %K Sex Distribution %K Surveys and Questionnaires %K Young adult %X

A standardised methodology for a combined point prevalence survey (PPS) on healthcare-associated infections (HAIs) and antimicrobial use in European acute care hospitals developed by the European Centre for Disease Prevention and Control was piloted across Europe. Variables were collected at national, hospital and patient level in 66 hospitals from 23 countries. A patient-based and a unit-based protocol were available. Feasibility was assessed via national and hospital questionnaires. Of 19,888 surveyed patients, 7.1% had an HAI and 34.6% were receiving at least one antimicrobial agent. Prevalence results were highest in intensive care units, with 28.1% patients with HAI, and 61.4% patients with antimicrobial use. Pneumonia and other lower respiratory tract infections (2.0% of patients; 95% confidence interval (CI): 1.8–2.2%) represented the most common type (25.7%) of HAI. Surgical prophylaxis was the indication for 17.3% of used antimicrobials and exceeded one day in 60.7% of cases. Risk factors in the patient-based protocol were provided for 98% or more of the included patients and all were independently associated with both presence of HAI and receiving an antimicrobial agent. The patient-based protocol required more work than the unit-based protocol, but allowed collecting detailed data and analysis of risk factors for HAI and antimicrobial use.

%B Euro Surveill %V 17 %8 2012 Nov 15 %G eng %N 46 %1 http://www.ncbi.nlm.nih.gov/pubmed/23171822?dopt=Abstract %0 Generic %D 2012 %T Fifty percent reduction of MRSA incidence in Belgian acute care hospitals: yes we can! %A Jans,B. %A Boudewijn Catry %A Costers,M. %A Karl Mertens %A Simon,A. %A O. Denis %K acute %K Acute care hospital %K Belgian %K care %K Clinical %K conference %K Congresses %K disease %K Diseases %K European %K hospital %K hospitals %K incidence %K Infection Control %K Infectious %K Infectious diseases %K Methicillin-Resistant Staphylococcus aureus %K microbiology %K MRSA %K poster %K PRESENTATION %K Reduction %B European Congress of Clinical Microbiology and Infectious Diseases %I NA %C NA %8 1/4/2012 %G eng %N European Society of Clinical Microbiology and Infectious Diseases %1 30974 %2 01/04/2012 %0 Journal Article %J Euro surveill. %D 2012 %T Four multifaceted countrywide campaigns to promote hand hygiene in Belgian hospitals between 2005 and 2011: impact on compliance to hand hygiene %A Costers,M. %A Viseur,N. %A Boudewijn Catry %A Simon,A. %K Belgian %K Combination %K compliance %K CONTACT %K Control %K exposure %K Hand %K Hand hygiene %K healthcare %K HEALTHCARE WORKERS %K HHM %K hospital %K hospitals %K Hygiene %K Impact %K INFECTION %K intervention %K observed %K ON %K outcome %K outcomes %K Patient %K performance %K period %K PHYSICIAN %K PHYSICIANS %K promotion %K RATES %K repeated %K result %K risk %K use %K worker %K Workers %X

Four consecutive one-month campaigns were organised to promote hand hygiene in Belgian hospitals between 2005 and 2011. The campaigns included a combination of reminders in wards, educational sessions for healthcare workers, promotion of alcohol-based hand rub use, increasing patient awareness, and audits with performance feedback. Prior and after each one month intervention period, the infection control teams measured hand hygiene compliance of healthcare workers by direct observation using a standardised observation roster. A total of 738,367 opportunities for hand hygiene were observed over the four campaigns. Compliance with hand hygiene significantly increased from 49.6% before to 68.6% after the intervention period for the first, from 53.2% to 69.5% for the second, from 58.0% to 69.1% for the third, and from 62.3% to 72.9% for the fourth campaign. The highest compliance rates were consistently observed in paediatric units. Compliance rates were always markedly lower among physicians than nurses. After patient contact and body fluid exposure risk, compliance rates were noticeably higher than before patient contact and performing aseptic procedures. We conclude that repeated countrywide campaigns to promote hand hygiene result in positive long-term outcomes. However, lower compliance rates among physicians compared with nurses, before patient contact, and before performing aseptic procedures remain challenges for future campaigns.

%B Euro surveill. %V 17 %8 3/5/2012 %G eng %N 18 %1 30826 %0 Journal Article %J Pharmacoepidemiol Drug Saf %D 2012 %T Indications for antimicrobial prescribing in European nursing homes: results from a point prevalence survey. %A Katrien Latour %A Boudewijn Catry %A Broex, Elisabeth %A Vankerckhoven, Vanessa %A Muller, Arno %A Stroobants, Rudi %A Goossens, Herman %A Beatrice Jans %K Adult %K Aged %K Aged, 80 and over %K Anti-Infective Agents %K antibiotic prophylaxis %K Drug Resistance, Microbial %K Drug Resistance, Multiple %K Europe %K Female %K Humans %K INFECTION %K Male %K middle aged %K nursing homes %K Practice Patterns, Physicians' %K Quality Assurance, Health Care %K Surveys and Questionnaires %X

PURPOSE: In light of the emerging problem with multiresistant microorganisms in nursing homes (NHs), the European Surveillance of Antimicrobial Consumption NH subproject was set up to measure and describe antimicrobial use across Europe. The aim of this paper was to investigate the indications for antimicrobial use and hence identify targets for quality improvement.

METHODS: Data were obtained from a point prevalence survey conducted in 323 NHs across 21 European countries. A resident questionnaire had to be completed for each resident receiving an antimicrobial, collecting data such as compound name and indication for antimicrobial prescribing. Four main indications for antimicrobial use were recorded: nasal decolonisation of methicillin-resistant Staphylococcus aureus (MRSA) carriage with mupirocin, prophylactic, empirical, and microbiologically documented treatments. The latter three treatment types were further subdivided according to the targeted infections.

RESULTS: In total, 1966 residents were treated with 2046 antimicrobials. Empirical treatments were most common (54.4% of all antimicrobial therapies; prevalence: 3.39 per 100 eligible residents), followed by prophylactic (28.8%; prevalence: 1.87%) and microbiologically documented (16.1%; prevalence: 1.01%) regimes. MRSA decolonisation with nasal mupirocin (0.7%; prevalence: 0.02%) was uncommon. Antimicrobials were most frequently prescribed for the prevention or treatment of urinary (49.5%; prevalence: 3.23%) and respiratory (31.8%; prevalence: 1.81%) tract infections. A very high proportion of uroprophylaxis was reported (25.6% of all prescribed antimicrobials; prevalence: 1.67%).

CONCLUSIONS: The indications for antimicrobial prescribing varied markedly between countries. We identified uroprophylaxis as a possible target for quality improvement.

%B Pharmacoepidemiol Drug Saf %V 21 %P 937-44 %8 2012 Sep %G eng %N 9 %1 http://www.ncbi.nlm.nih.gov/pubmed/22271462?dopt=Abstract %R 10.1002/pds.3196 %0 Journal Article %J Epidemiol Infect %D 2012 %T Livestock veterinarians at high risk of acquiring methicillin-resistant Staphylococcus aureus ST398. %A Cristina Garcia-Graells %A Jérôme Antoine %A Larsen, J %A Boudewijn Catry %A Skov, R %A Denis, O %K Animals %K Belgium %K Carrier State %K denmark %K Drug Resistance, Multiple, Bacterial %K Genotype %K Livestock %K Methicillin-Resistant Staphylococcus aureus %K Molecular Typing %K Occupational Exposure %K prevalence %K Risk Assessment %K Staphylococcal Infections %K Swine %K Veterinarians %X

The prevalence and risk factors associated with livestock-associated MRSA (LA-MRSA) carriage was examined in Danish and Belgian veterinarians. The MRSA and LA-MRSA carriage rates were 9·5% (95% CI 5·3-15·6) and 7·5% (95% CI 3·8-13·1) for MRSA and LA-MRSA, respectively, in Belgium and 1·4% (95% CI: 0·17-5·05) in Denmark (all Danish MRSA isolates belonged to the LA-MRSA genotype). All LA-MRSA isolates were resistant to tetracycline and 53·4% (7/13) showed a multi-resistant phenotype. LA-MRSA was significantly associated with veterinarians in contact with livestock (P=0·046). In the multivariable analysis, working with small animals in a veterinary clinic seems to be negatively associated (OR 0·15, 95% CI 0-1·0, P=0·05) and a strong direct association was found for LA-MRSA acquisition and exposure to live pigs (OR 12·1, 95% CI 1·6-548·5, P=0·01). Since carriage of MRSA ST398 may increase the risk of complications during hospitalization, our results underline that preventive measures may need to be developed for veterinary professionals, particularly for livestock veterinarians.

%B Epidemiol Infect %V 140 %P 383-9 %8 2012 Mar %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/22082716?dopt=Abstract %R 10.1017/S0950268811002263 %0 Journal Article %J Eur J Clin Microbiol Infect Dis %D 2012 %T Previous healthcare exposure is the main antecedent for methicillin-resistant Staphylococcus aureus carriage on hospital admission in Belgium. %A Vandendriessche, S %A Hallin, M %A Boudewijn Catry %A Jans, B %A Deplano, A %A Nonhoff, C %A Roisin, S %A de Mendonça, R %A Struelens, M J %A Denis, O %K ADOLESCENT %K Adult %K Aged %K Aged, 80 and over %K Bacterial Toxins %K Belgium %K Carrier State %K Child %K Child, Preschool %K Cluster Analysis %K Diagnostic Tests, Routine %K Exotoxins %K Female %K hospitals %K Humans %K Infant %K Infant, Newborn %K Leukocidins %K Male %K Methicillin-Resistant Staphylococcus aureus %K middle aged %K Molecular Epidemiology %K Molecular Typing %K prevalence %K Risk Factors %K Staphylococcal Infections %K Young adult %X

This study aimed to estimate the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) carriage upon hospital admission and to study the molecular epidemiology of MRSA in order to assess the proportion of Panton-Valentine leukocidin (PVL)-positive community-associated (CA) and livestock-associated (LA) MRSA strains. Epidemiological data on MRSA carriage upon hospital admission (2006-2009) were collected in a compulsory, continuous, national MRSA surveillance in Belgian acute-care hospitals. Additionally, 328 MRSA strains in 2005 and 314 strains in 2008 were collected in a separate, multicenter microbiological survey. Spa-typing, SCCmec-typing and MLST were performed; toxin genes were detected by PCR. The overall prevalence of MRSA carriage upon hospital admission was 8.9 cases/1,000 admissions between 2006 and 2009. Of MRSA carriers, 37.5% had a known MRSA history, 39.4% had stayed in a care facility, 12.2% reported no contact with healthcare. Over 90% of MRSA belonged to five healthcare-associated clones. Of these, MRSA spa-CC038-ST45-IV was in decline, mainly in favor of spa-CC008-ST8-IV. MRSA spa-CC002-ST5-IV, spa-CC002-ST5-II and spa-CC032-ST22-IV remained relatively stable. The proportion of PVL-positive CA-MRSA and LA-MRSA ST398 was below 2% of all MRSA. The extra-hospital MRSA reservoir in Belgium mainly consists of persons with previous healthcare exposure. PVL-positive CA-MRSA and LA-MRSA strains remained infrequent among hospitalized patients.

%B Eur J Clin Microbiol Infect Dis %V 31 %P 2283-92 %8 2012 Sep %G eng %N 9 %1 http://www.ncbi.nlm.nih.gov/pubmed/22382816?dopt=Abstract %& 2283 %R 10.1007/s10096-012-1567-0 %0 Journal Article %J Prev.Vet.Med. %D 2012 %T Prophylactic and metaphylactic antimicrobial use in Belgian fattening pig herds %A Bénédicte Callens %A Persoons,D. %A Maes,D. %A Laanen,M. %A Postma,M. %A Boyen,F. %A Haesebrouck,F. %A Butaye,P. %A Boudewijn Catry %A Dewulf,J. %K 0 %K 2010 %K administration & dosage %K Agent %K Agents %K ALL %K Amoxicillin %K an %K Animal %K Animals %K Anti-Bacterial Agents %K antibiotic prophylaxis %K Antimicrobial %K Antimicrobial resistance %K antimicrobial use %K Antimicrobials %K article %K at %K Belgian %K Belgium %K Colistin %K Control %K data %K Dose-Response Relationship,Drug %K Doxycycline %K DRUG %K Drug Resistance,Bacterial %K drug therapy %K drugs %K electronic %K epidemiology %K Female %K Guidelines %K health %K im %K incidence %K IS %K IT %K journal %K LEVEL %K Male %K Monitoring %K national %K Obstetrics %K ON %K Pig %K Pigs %K Population Surveillance %K Practice Guidelines as Topic %K prevention & control %K PRODUCTS %K reproduction %K Research %K Research Support %K resistance %K Retrospective Studies %K risk %K SB - IM %K Selection %K Spread %K study %K Swine %K Swine Diseases %K therapeutic use %K treatment %K Tylosin %K Universities %K university %K use %K veterinary %X The monitoring of antimicrobial use is an essential step to control the selection and spread of antimicrobial resistance. Between January and October 2010 data on prophylactic and metaphylactic antimicrobial use were collected retrospectively on 50 closed or semi-closed pig herds. Ninety-three percent of the group treatments were prophylactic whereas only 7% were methaphylactic. The most frequently used antimicrobials orally applied at group level were colistin (30.7%), amoxicillin (30.0%), trimethoprim-sulfonamides (13.1%), doxycycline (9.9%) and tylosin (8.1%). The most frequently applied injectable antimicrobials were tulathromycin (45.0%), long acting ceftiofur (40.1%) and long acting amoxicillin (8.4%). The treatment incidences (TI) based on the used daily dose pig (UDD(pig) or the actually administered dose per day per kg pig of a drug) for all oral and injectable antimicrobial drugs was on average 200.7 per 1000 pigs at risk per day (min=0, max=699.0), while the TI based on the animal daily dose pig (ADD(pig) or the national defined average maintenance dose per day per kg pig of a drug used for its main indication) was slightly higher (average=235.8, min=0, max=1322.1). This indicates that in reality fewer pigs were treated with the same amount of antimicrobials than theoretically possible. Injectable products were generally overdosed (79.5%), whereas oral treatments were often underdosed (47.3%). In conclusion, this study shows that prophylactic group treatment was applied in 98% of the visited herds and often includes the use of critically important and broad-spectrum antimicrobials. In Belgium, the guidelines for prudent use of antimicrobials are not yet implemented %B Prev.Vet.Med. %V 106 %P 53 - 62 %8 1/9/2012 %G eng %N 1 %1 35267 %& 53 %R http://dx.doi.org/10.1016/j.prevetmed.2012.03.001 %0 Journal Article %J J.Antimicrob.Chemother. %D 2012 %T Prospective study on quantitative and qualitative antimicrobial and anti-inflammatory drug use in white veal calves %A Pardon,B. %A Boudewijn Catry %A Dewulf,J. %A Persoons,D. %A Hostens,M. %A De Bleecker,K. %A Deprez,P. %K 0 %K Agent %K Agents %K ALL %K Amoxicillin %K an %K Animal %K Animals %K Anti-Bacterial Agents %K Anti-Inflammatory Agents %K Antimicrobial %K antimicrobial use %K Antimicrobials %K article %K AS %K at %K Belgium %K Cattle %K Cattle Diseases %K Colistin %K Combination %K CONSUMPTION %K data %K disease %K DRUG %K drug consumption %K drug therapy %K Drug Utilization %K electronic %K factors %K Faculty %K feed %K im %K incidence %K Industries %K Industry %K INFORMATION %K internal medicine %K IS %K IT %K journal %K linear regression %K Medicine %K method %K methods %K n %K objectives %K ON %K Oxytetracycline %K p %K plant %K production %K Prospective Studies %K qualitative %K recommendation %K Recommendations %K reducing %K Reduction %K regression %K Research %K Research Support %K resistance %K Respiratory %K result %K results %K risk %K Risk Factors %K SB - IM %K statistics & numerical data %K study %K System %K therapeutic use %K treatment %K Tylosin %K Universities %K university %K use %K veterinary %X OBJECTIVES: To document and quantify drug use in white veal calves, an intensive livestock production system where multidrug resistance is abundantly present. METHODS: Drug consumption data were prospectively collected on 15 white veal production cohorts (n = 5853 calves) in Belgium (2007-09). Treatment incidences (TIs) based on animal defined daily dose (ADD), prescribed daily dose (PDD) and used daily dose (UDD) were calculated. Risk factors were identified by linear regression. RESULTS: The average TI(ADD) of antimicrobial treatments was 416.8 ADD per 1000 animals at risk. Predominantly, oral group antimicrobial treatments were used (95.8%). Of the oral group antimicrobial treatments, 12% and 88% were used for prophylactic or metaphylactic indications, respectively. The main indication for group and individual drug use was respiratory disease. The most frequently used antimicrobials (group treatments) were oxytetracycline (23.7%), amoxicillin (18.5%), tylosin (17.2%) and colistin (15.2%). Deviations from the leaflet dosage recommendations were frequently encountered, with 43.7% of the group treatments underdosed (often oxytetracycline and tylosin to treat dysbacteriosis). In 33.3% of the oral antimicrobial group treatments a combination of two antimicrobial preparations was used. Smaller integrations used more antimicrobials in group treatments than larger ones (P < 0.05); an integration is defined as a company that combines all steps of the production chain by having its own feed plant and slaughterhouse and by placing its calves in veal herds owned by producers that fatten these calves for this integration on contract. Producers used higher dosages than prescribed by the veterinarian in cohorts with a single caretaker (P < 0.01). CONCLUSIONS: The present study provided detailed information on the intensive antimicrobial use in the white veal industry. Reduction can only be achieved by reducing the number of oral group treatments %B J.Antimicrob.Chemother. %V 67 %P 1027 - 1038 %8 0/4/2012 %G eng %N 4 %1 35299 %& 1027 %R http://dx.doi.org/10.1093/jac/dkr570 %0 Generic %D 2012 %T Surveillance van IZ-verworven infecties. %A Karl Mertens %A Boudewijn Catry %E De Moerloose,K. %K infecties %K infections %K intensive care %K Surveillance %B Ziekenhuis Ronse %8 27/1/2012 %G eng %N De Moerloose,K. %1 31040 %2 27/01/2012 %0 Journal Article %J Microb Drug Resist %D 2011 %T The importance of sample size in the determination of a flock-level antimicrobial resistance profile for Escherichia coli in broilers. %A Persoons, Davy %A Bollaerts, Kaatje %A Smet, Annemieke %A Herman, Lieve %A Heyndrickx, Marc %A Martel, An %A Butaye, Patrick %A Boudewijn Catry %A Haesebrouck, Freddy %A Dewulf, Jeroen %K Animal Husbandry %K Animals %K Anti-Bacterial Agents %K Belgium %K Chickens %K Colony Count, Microbial %K Drug Resistance, Bacterial %K Escherichia coli %K Escherichia coli Infections %K Microbial Sensitivity Tests %K Poultry Diseases %K prevalence %K Sample Size %X

Determining herd- or flock-specific antimicrobial resistance profiles is important to guide therapeutic use of antimicrobials and to assess risk factors for the development and spread of antimicrobial resistance. As such, it is of utmost importance to optimize the sampling strategy for the determination of herd-specific antimicrobial resistance profiles. However, the multitude of prevalences measured at the same time as well as the presence of variation both at the level of the animal and the bacterial population of concern make it impossible to use conventional sample size determination methods. In this article, the use of bootstrapping techniques for sample size determination was explored. In particular, one-stage and two-stage bootstrap samplings were used to determine the optimal number of animals and the optimal number of isolates within one animal. Results show that focus should be on the number of animals sampled rather than on the number of isolates tested within one animal.

%B Microb Drug Resist %V 17 %P 513-9 %8 2011 Dec %G eng %N 4 %1 http://www.ncbi.nlm.nih.gov/pubmed/21875337?dopt=Abstract %R 10.1089/mdr.2011.0048 %0 Journal Article %J Euro Surveill %D 2011 %T Nosocomial and non-nosocomial Clostridium difficile infections in hospitalised patients in Belgium: compulsory surveillance data from 2008 to 2010. %A Viseur, N %A Marie-Laurence Lambert %A Delmée, M %A Van Broeck, J %A Boudewijn Catry %K Age Distribution %K Aged %K Aged, 80 and over %K Belgium %K Clostridium difficile %K Clostridium Infections %K Cross Infection %K Female %K Hospitalization %K hospitals %K Humans %K incidence %K Male %K middle aged %K Population Surveillance %K Ribotyping %X

Surveillance of Clostridium difficile infection (CDI) is compulsory in Belgian hospitals. Our objectives were to compare incidence and case characteristics of nosocomial infections (Nc-CDI) with onset of diarrhoea more than two days after hospital admission, with non-nosocomial cases (Nnc-CDI). The database included inpatients from 2008 to 2010. Of 8,351 cases reported by 150 hospitals, 3,102 (37%) were classified as Nnc-CDI and 5,249 (63%) as Nc-CDI. In 2010, the mean incidence per 1,000 admissions was 0.95 for Nc-CDI and 0.56 for Nnc-CDI. Both incidences were relatively stable over the three years, with a slight decrease in 2010 (p<0.01). Onset of symptoms in Nnc- CDI cases took place in the community (57.1%), nursing homes (14.2%) or hospitals (17.5%); data for 11.2%were missing. Nnc-CDI cases were younger than Nc-CDI (median age 75 vs. 79 years, p<0.001), and more likely to be women (62% vs. 57%, p<0.001) and to have pseudomembranous colitis (5.3% vs. 1.6%, p<0.001). In 2009, C. difficile ribotype 027 was found in 32 of 70 reporting hospitals compared with 19 of 69 in 2010 (p<0.03). Although our study population only included hospitalised patients, the results do not support the hypothesis of an increase in the incidence of severe community-associated CDI.

%B Euro Surveill %V 16 %8 2011 Oct 27 %G eng %N 43 %1 http://www.ncbi.nlm.nih.gov/pubmed/22085603?dopt=Abstract %0 Journal Article %J Drugs Aging %D 2011 %T Parenteral versus oral administration of systemic antimicrobials in European nursing homes: a point-prevalence survey. %A Broex, Elisabeth %A Boudewijn Catry %A Katrien Latour %A Karl Mertens %A Vankerckhoven, Vanessa %A Muller, Arno %A Stroobants, Rudi %A Zarb, Peter %A Goossens, Herman %A Beatrice Jans %K Administration, Oral %K Aged, 80 and over %K Anti-Infective Agents %K Data collection %K Drug Prescriptions %K Europe %K Female %K Homes for the Aged %K Humans %K Male %K nursing homes %X

BACKGROUND: Residents in long-term care facilities are predisposed to healthcare-associated infections that are likely caused by antimicrobial-resistant micro-organisms. Long-term care facilities are increasingly able to offer parenteral antimicrobial treatment but there are few data on the use and appropriateness of such treatment in this setting. Information on the use of parenteral antimicrobials and associated factors in long-term care facilities is necessary to assess the risks and benefits of this treatment and to support the development of antimicrobial policies aimed at minimizing the emergence and spread of antimicrobial resistance.

OBJECTIVE: The aim of this study was to describe the extent of parenteral and oral antimicrobial use in participating European nursing homes (NHs) and to analyse the resident characteristics and determinants associated with route of antimicrobial administration.

METHODS: Data on resident characteristics and antimicrobials were collected by means of a point-prevalence survey. Logistic regression was used to analyse the data.

RESULTS: Based on data from 21 European countries for 2046 antimicrobial prescriptions, an average of 9.0% (range by country: 0.0-66.7%) of treatment was administered parenterally. Multivariate analysis showed that residents receiving parenteral antimicrobials had greater morbidity, such as increased risk of having a urinary catheter (p < 0.001), a vascular catheter (p < 0.001), impaired mobility (p = 0.007) and disorientation (p = 0.005). Residents receiving parenteral antimicrobials also had been admitted more recently into the NH (p = 0.007). Empirical treatment of respiratory tract infections (RTIs) accounted for the majority of parenteral antimicrobials, while prophylaxis of urinary tract infection (UTI) was the most common indication for oral antimicrobials. Beta-lactam antibacterials (cephalosporins and aminopenicillins) were the predominant classes used.

CONCLUSIONS: Our study showed that risk and care-load factors (i.e. the presence of a urinary or vascular catheter, impaired mobility, disorientation and relatively short length of stay) were associated with parenteral administration of antimicrobials in NHs. Furthermore, both the indication and the class of antimicrobial agent used were associated with administration route. For empirical treatment of RTIs, antimicrobials were most often administered parenterally.

%B Drugs Aging %V 28 %P 809-18 %8 2011 Oct 01 %G eng %N 10 %1 http://www.ncbi.nlm.nih.gov/pubmed/21970308?dopt=Abstract %R 10.2165/11595350-000000000-00000 %0 Journal Article %J Vet Rec %D 2011 %T Prevalence of respiratory pathogens in diseased, non-vaccinated, routinely medicated veal calves. %A Pardon, B %A De Bleecker, K %A Dewulf, J %A Callens, J %A Boyen, F %A Boudewijn Catry %A Deprez, P %K Animals %K Antibodies, Bacterial %K Antibodies, Viral %K Belgium %K Cattle %K Cattle Diseases %K Disease Outbreaks %K Lung %K Mycoplasma %K Respiratory Syncytial Virus, Bovine %K Respiratory Tract Infections %K Species Specificity %X

The prevalence of respiratory pathogens in diseased veal calves was determined in 24 respiratory disease outbreaks in 15 herds in Belgium. Bacteria were cultured from nasopharyngeal swabs and seroconversion against viruses and Mycoplasma bovis was determined on paired sera. At the individual calf level, Mycoplasma species, Mannheimia haemolytica and Pasteurella multocida, were isolated from 70.5 per cent, 21.5 per cent and 26.0 per cent of swabs, respectively. At the herd level, the presence of M bovis could be confirmed in 84.6 per cent of the herds examined. Seroconversion against bovine viral diarrhoea virus (BVDV) was present in 71.4 per cent of herds, parainfluenzavirus type 3 in 53.3 per cent, bovine respiratory syncytial virus in 40.0 per cent, bovine adenovirus type 3 in 46.7 per cent, bovine coronavirus in 30.0 per cent, and bovine herpesvirus type 1 in 26.7 per cent. At postmortem examination, Mycoplasma species could be cultured from 61.9 per cent of pneumonic lungs (n=21). Sixty per cent of calves tested were positive for BVDV (n=20), and 20.0 per cent were positive for bovine respiratory syncytial virus (n=16).

%B Vet Rec %V 169 %P 278 %8 2011 Sep 10 %G eng %N 11 %1 http://www.ncbi.nlm.nih.gov/pubmed/21831999?dopt=Abstract %R 10.1136/vr.d4406 %0 Journal Article %J J Antimicrob Chemother %D 2011 %T Review on methicillin-resistant Staphylococcus pseudintermedius. %A van Duijkeren, Engeline %A Boudewijn Catry %A Greko, Christina %A Moreno, Miguel A %A M Constança Pomba %A Pyörälä, Satu %A Ruzauskas, Modestas %A Sanders, Pascal %A Threlfall, E John %A Torren-Edo, Jordi %A Törneke, Karolina %K Animals %K Anti-Bacterial Agents %K Cat Diseases %K Cats %K Dog Diseases %K Dogs %K Humans %K methicillin %K Methicillin Resistance %K Pets %K prevalence %K Staphylococcal Infections %K staphylococcus %K Zoonoses %X

Staphylococcus pseudintermedius is an important opportunistic pathogen of companion animals, especially dogs. Since 2006 there has been a significant emergence of methicillin-resistant S. pseudintermedius (MRSP) mainly due to clonal spread. This article reviews research on MRSP with a focus on occurrence, methods used for identification, risk factors for colonization and infection, zoonotic potential and control options. Potential areas for future research are also discussed.

%B J Antimicrob Chemother %V 66 %P 2705-14 %8 2011 Dec %G eng %N 12 %1 http://www.ncbi.nlm.nih.gov/pubmed/21930571?dopt=Abstract %R 10.1093/jac/dkr367 %0 Journal Article %J Epidemiol Infect %D 2011 %T Risk factors for ceftiofur resistance in Escherichia coli from Belgian broilers. %A Persoons, D %A Haesebrouck, F %A Smet, A %A Herman, L %A Heyndrickx, M %A Martel, A %A Boudewijn Catry %A Berge, A C %A Butaye, P %A Dewulf, J %K Animals %K Anti-Bacterial Agents %K Belgium %K Cephalosporins %K Chickens %K cross-sectional studies %K Drug Resistance, Bacterial %K Escherichia coli %K Escherichia coli Infections %K Microbial Sensitivity Tests %K Risk Factors %K Surveys and Questionnaires %X

A cross-sectional study on 32 different Belgian broiler farms was performed in 2007 and 2008 to identify risk factors for ceftiofur resistance in Escherichia coli. On each farm, one E. coli colony was isolated from 30 random birds. Following susceptibility testing of 14 antimicrobials, an on-farm questionnaire was used to obtain information on risk factors. Using a multilevel logistic regression model two factors were identified at the animal level: resistance to amoxicillin and to trimethoprim-sulfonamide. On the farm level, besides antimicrobial use, seven management factors were found to be associated with the occurrence of ceftiofur resistance in E. coli from broilers: poor hygienic condition of the medicinal treatment reservoir, no acidification of drinking water, more than three feed changes during the production cycle, hatchery of origin, breed, litter material used, and treatment with amoxicillin. This study confirms that not only on-farm antimicrobial therapy, but also management- and hatchery-related factors influence the occurrence of antimicrobial resistance.

%B Epidemiol Infect %V 139 %P 765-71 %8 2011 May %G eng %N 5 %1 http://www.ncbi.nlm.nih.gov/pubmed/20587122?dopt=Abstract %R 10.1017/S0950268810001524 %0 Journal Article %J Microb Drug Resist %D 2010 %T Prevalence and persistence of antimicrobial resistance in broiler indicator bacteria. %A Persoons, Davy %A Dewulf, Jeroen %A Smet, Annemieke %A Herman, Lieve %A Heyndrickx, Marc %A Martel, An %A Boudewijn Catry %A Butaye, Patrick %A Haesebrouck, Freddy %K Animals %K Anti-Bacterial Agents %K Bird Diseases %K Chickens %K Drug Resistance, Multiple, Bacterial %K Enterococcus faecium %K Escherichia coli %K Escherichia coli Infections %K Food Microbiology %K Gram-Positive Bacterial Infections %K Microbial Sensitivity Tests %K Poultry Products %K prevalence %X

This study explored the prevalence and persistence of acquired antimicrobial resistance in Escherichia coli and Enterococcus faecium from healthy broilers. In 32 broiler farms, cloacal samples were taken during two production rounds, with one production round in between. For 10 of the sampled flocks, samples from the carcasses at the slaughterhouse were also collected. For E. coli, high levels of resistance were found for ampicillin, nalidixic acid, streptomycin, tetracycline, and the combination of trimethoprim and sulfonamide. Over 58% of all the isolates showed resistance to four or more antimicrobial agents. Only 4.8% were fully susceptible for all 14 drugs tested. A remarkably high resistance rate (up to 41%) to ceftiofur was found. The enterococci were frequently resistant to macrolides, tetracycline, and the combination quinopristin/dalfopristin. Over 80% displayed acquired resistance to four or more antimicrobial agents, and 3.9% were fully susceptible for the eight agents tested. Resistance was found to persist over consecutive production rounds. There was a good correlation between results obtained with cloacal samples of the live animals and caecal content samples collected in the slaughterhouse for both E. coli and E. faecium. For E. coli but not for E. faecium, the resistance profile of neck skin isolates was different from that of cloacal isolates.

%B Microb Drug Resist %V 16 %P 67-74 %8 2010 Mar %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/19958160?dopt=Abstract %R 10.1089/mdr.2009.0062 %0 Journal Article %J Epidemiol Infect %D 2010 %T Reflection paper on MRSA in food-producing and companion animals: epidemiology and control options for human and animal health. %A Boudewijn Catry %A Van Duijkeren, E %A Pomba, M C %A Greko, C %A Moreno, M A %A Pyörälä, S %A Ruzauskas, M %A Sanders, P %A Threlfall, E J %A Ungemach, F %A Törneke, K %A Munoz-Madero, C %A Torren-Edo, J %K Animals %K Animals, Domestic %K Carrier State %K Food Microbiology %K Humans %K Infection Control %K Methicillin-Resistant Staphylococcus aureus %K Staphylococcal Infections %K Zoonoses %X

The scope of this reflection paper was to review the latest research on the risk of MRSA infection and colonization in animals. Attention focused on occurrence, risk factors for colonization and infection, and human contact hazard for livestock, horses, and companion animals. Whereas the clonal relationship between MRSA strains of CC398 is straightforward in livestock this is less obvious in horses. Small companion animals typically share MRSA strains that seem to exchange with a human reservoir. Management and therapeutic options have been suggested for livestock, horses, companion animals, as well as instructions on safety measures for persons in contact with animals. Conclusions were drawn with emphasis on future research activities, especially to confirm the apparent evolution of the organism and to demonstrate efficiency of control strategies.

%B Epidemiol Infect %V 138 %P 626-44 %8 2010 May %G eng %N 5 %1 http://www.ncbi.nlm.nih.gov/pubmed/20141646?dopt=Abstract %R 10.1017/S0950268810000014 %0 Report %D 2010 %T Surveillance des syndromes grippaux en maison de repos et de soins en Belgique, 2009-2010 %A Beatrice Jans %A Katrien Latour %A Broex, Ellen %A Boudewijn Catry %K 2009 %K 2010 %K Belgique %K maison de repos et de soins %K Surveillance %K syndromes grippaux %X

NA

%I WIV-ISP %C Brussels, Belgium %P 13 %8 09/2010 %G eng %M D/2010/2505/66 %0 Journal Article %J Archives of Public Health %D 2010 %T Surveillance of influenza-like illness in Belgian nursing homes %A Jans, B %A Katrien Latour %A Broex, E %A Boudewijn Catry %B Archives of Public Health %V 68 %8 Jan-12-2010 %G eng %N 3 %R 10.1186/0778-7367-68-3-100 %0 Report %D 2010 %T Surveillance van Influenza-like illness in Belgische woonzorgcentra, 2009-2010 %A Beatrice Jans %A Katrien Latour %A Broex, Ellen %A Boudewijn Catry %K 2009 %K 2010 %K België %K griepaal syndroom %K Influenza-like illness %K Surveillance %K woonzorgcentra %X

NA

%I WIV-ISP %C Brussels, Belgium %P 13 %8 09/2010 %G eng %M D/2010/2505/65 %0 Journal Article %J Emerg Infect Dis %D 2009 %T Methicillin-resistant Staphylococcus aureus ST398 in swine farm personnel, Belgium. %A Denis, Olivier %A Suetens, Carl %A Hallin, Marie %A Boudewijn Catry %A Ramboer, Ilse %A Marc Dispas %A Willems, Glenda %A Gordts, Bart %A Butaye, Patrick %A Struelens, Marc J %K Agriculture %K Animals %K Belgium %K Clothing %K Humans %K Methicillin Resistance %K Methicillin-Resistant Staphylococcus aureus %K Risk Factors %K Skin Diseases, Bacterial %K Staphylococcal Infections %K Swine %X

We assessed methicillin-resistant Staphylococcus aureus (MRSA) in persons on 49 swine farms in Belgium. Surveys showed that 48 (37.8%) persons carried MRSA ST398 and 1 (0.8%) had concurrent skin infection. Risk factors for carriage were MRSA carriage by pigs, regular contact with pigs and companion animals, and use of protective clothing.

%B Emerg Infect Dis %V 15 %P 1098-101 %8 2009 Jul %G eng %N 7 %1 http://www.ncbi.nlm.nih.gov/pubmed/19624929?dopt=Abstract %R 10.3201/eid1507.080652 %0 Report %D 2009 %T Systemic antimicrobial drug use in Belgian hospitals, 2006-2007 %A Vaerenberg,S. %A Hendrickx, E %A Boudewijn Catry %K antimicrobial drug use %K Belgium %K hospitals %K systemic %X

NA

%I WIV-ISP %C Brussels, Belgium %P 72 %8 07/2009 %G eng %M D/2009/2505/43 %0 Journal Article %J J Vet Pharmacol Ther %D 2008 %T Efficacy of metaphylactic florfenicol therapy during natural outbreaks of bovine respiratory disease. %A Boudewijn Catry %A Duchateau, L %A Van de Ven, J %A Laevens, H %A Opsomer, G %A Haesebrouck, F %A de Kruif, A %K Animals %K Anti-Bacterial Agents %K Body Temperature %K Body weight %K Cattle %K Cattle Diseases %K Disease Outbreaks %K Male %K Mycoplasma bovis %K Mycoplasma Infections %K Netherlands %K Pasteurella Infections %K Pasteurella multocida %K Respiratory Tract Infections %K Thiamphenicol %K Tylosin %X

The efficacy of an injectable formulation of florfenicol (300 mg/mL) as metaphylactic control of naturally occurring bovine respiratory disease (BRD) was evaluated in two double-blind randomly controlled field studies on two Dutch veal calf herds (A and B). Cattle aged not older than 3 months and in the direct presence of calves with clinical respiratory disease were randomly allocated to treatment with 40 mg/kg florfenicol subcutaneously (s.c.) a positive control treatment (12.5 mg/kg tilmicosin p.o. twice daily for five consecutive days in herd A, and 12.5 mg/kg doxycycline p.o. twice daily for five consecutive days in herd B), or a negative control (one placebo saline s.c. administration on D0). The predominant respiratory pathogens present in pretreatment respiratory samples from affected animals were Mycoplasma bovis and Pasteurella multocida in outbreaks A and B, respectively. Metaphylactic administration of florfenicol resulted in a statistically significant weight gain, decreased rectal temperature for five consecutive days after treatment and decreased metaphylactic failure percentages compared with both positive and negative control groups. In summary, these studies demonstrated that a single s.c. injection of florfenicol is effective and practical for control of the bacterial component of BRD in veal calves.

%B J Vet Pharmacol Ther %V 31 %P 479-87 %8 2008 Oct %G eng %N 5 %1 http://www.ncbi.nlm.nih.gov/pubmed/19000268?dopt=Abstract %R 10.1111/j.1365-2885.2008.00981.x %0 Report %D 2008 %T Muticentrische studie "Verband tussen antibioticaconsumptie en microbile resistentie bij de individuele patiënt" %A Boudewijn Catry %A Hendrickx, E %A Preal, R %A Mertens, R %K ANTIBIOTICACONSUMPTIE %K MICROBIËLE RESISTENTIE %K MULTICENTRISCHE STUDIE %K Patient %X

Antimicrobial resistance leads to increased healthcare costs primordially due to a higher morbidity and mortality from infectious diseases, and increased length of hospital stay. The relationship between antimicrobial consumption and antimicrobial resistance is complex and remains far from fully understood. The objective of the present study was to investigate the relationship between the average daily intake of antimicrobial agents and the occurrence of microbial drug resistant organisms, in particular well known pathogens, at the individual patient level both in the ambulatory and in the in-patient setting. The microbiological results of voluntary participating clinical laboratories during 2005 were coupled with the antimicrobial consumption patterns (July 2004- December 2005) as provided by the pooled data of the seven Belgian health insurance funds (intermutualistic agency). Univariate and multivariate logistic regression were used to identify risk factors for antimicrobial resistance following antimicrobial consumption and other patient characteristics (calculation of Odd’s Ratios). A total of 105,198 samples, originating from 16 laboratories and 44,365 patients matched the criteria for further analysis through subsets of combinations of microorganisms and susceptibility profiles. Herein only the first isolate per patient was retained so as to minimize confounding through underlying disease and/or severity of infection. For Staphylococcus aureus, coagulase negative staphylococci, Escherichia coli, and Klebsiella pneumoniae, strong significant relationships (p<0.001) were found between their resistance profiles and the individual consumption of antimicrobial agents expressed as defined daily doses (DDD). This was especially the case for older and newer beta-lactam antibiotics (incl. cephalosporins) and for fluoroquinolones. These three groups of antimicrobial agents counted for 63.45% of total antimicrobial consumption within the study population. For Streptococcus pneumoniae, resistance to penicillines was increased by the use of the group of macrolides, lincosamides and streptogramines. These data strongly support the existence of a risk for acquired antimicrobial resistance in major bacterial pathogens, directly related to the consumption of antimicrobial agents at the individual patient level. When prescribing these agents of vital importance, clinicians should consider that antimicrobial consumption also inherently bears an individual risk for their own patient, besides the resistance induction at the population level that has been known for a long time. 

%I WIV-ISP/IMA/BAPCOC %C Brussels, Belgium %P 37 %8 11/2008 %G eng %M NA %0 Journal Article %J Vet Microbiol %D 2007 %T Recovery of Moraxella ovis from the bovine respiratory tract and differentiation of Moraxella species by tDNA-intergenic spacer PCR. %A Boudewijn Catry %A Boyen, Filip %A Baele, Margo %A Dewulf, Jeroen %A de Kruif, Aart %A Vaneechoutte, Mario %A Haesebrouck, Freddy %A Decostere, Annemie %K Animals %K Anti-Infective Agents %K Antineoplastic Agents %K Cattle %K Cattle Diseases %K DNA Primers %K DNA, Intergenic %K Microbial Sensitivity Tests %K Moraxella %K Moraxellaceae Infections %K polymerase chain reaction %K Polymorphism, Genetic %K Respiratory Tract Infections %K Species Specificity %X

The purpose of the present study was to identify Moraxella (M.)--like organisms recovered from calves suffering from respiratory disease down to species level by means of tDNA-intergenic spacer length polymorphism analysis (tDNA-PCR), and to perform antimicrobial susceptibility testing of these isolates using an agar dilution technique. A total of 16 isolates originating from 12 unrelated occasions were identified as Moraxella ovis, and tDNA fingerprinting showed clear delineation from other Moraxella species. The minimal inhibitory concentrations (in microg/mL) for 90% of the investigated isolates were < or =0.03 for ampicillin; 0.25 for ceftiofur; 0.5 for oxytetracycline; 8 for gentamicin; 64 for spectinomycin; 0.5/9.5 for the combination trimethoprim-sulfonamides; 4 for erythromycin; 8 for tilmicosin; 1 for florfenicol and 0.125 for enrofloxacin.

%B Vet Microbiol %V 120 %P 375-80 %8 2007 Mar 10 %G eng %N 3-4 %1 http://www.ncbi.nlm.nih.gov/pubmed/17141983?dopt=Abstract %R 10.1016/j.vetmic.2006.10.037 %0 Journal Article %J Prev Vet Med %D 2007 %T Tetracycline-resistance in lactose-positive enteric coliforms originating from Belgian fattening pigs: degree of resistance, multiple resistance and risk factors. %A Dewulf, J %A Boudewijn Catry %A Timmerman, T %A Opsomer, G %A de Kruif, A %A Maes, D %K Animal Husbandry %K Animals %K Anti-Bacterial Agents %K Belgium %K Colony Count, Microbial %K Drug Resistance, Multiple, Bacterial %K Enterobacteriaceae %K Enterobacteriaceae Infections %K Feces %K Lactose %K Microbial Sensitivity Tests %K Risk Factors %K Surveys and Questionnaires %K Swine %K Swine Diseases %K Tetracycline %K Tetracycline Resistance %X

Between March and October 2003 a field study was conducted in 50 randomly selected pig herds to assess the degree of tetracycline-resistance in lactose-positive enteric coliforms (LPEC) originating from fattening pigs and to evaluate the combined effects of various husbandry conditions on the development and persistence of antimicrobial-resistant bacteria. Data on housing, management and antimicrobial-drug consumption were collected, as well as faecal samples at three production stages: end of the nursery period (mean age: 72 days), end of the grower period (mean age: 125 days) and end of the finisher period (mean age: 186 days). The degree of tetracycline-resistant LPEC was determined by means of an agar dilution method. Tetracycline-resistant LPEC were found in every herd. The overall degree of tetracycline-resistance in LPEC was 56.8% (S.D. 22.4%). Only a very weak relation was found between the degrees of TETR in the different production stages within the same herd, indicating that the degree of TETR is mainly associated with the production stage rather than with the farm as a whole. The risk factor analysis showed that besides the antimicrobial-drug use, other factors like inside pen hygiene can influence the development and maintenance of antimicrobial-resistant bacteria in the gastrointestinal tracts of pigs. It was also observed that tetracycline-resistance in commensal Escherichia coli is often linked with resistance to other antimicrobial drugs like ampicillin and trimethoprim-sulphonamides. These results illustrate that the epidemiology of antimicrobial resistance is influenced by antimicrobial-drug use, cross-resistance development and non-antimicrobial risk factors.

%B Prev Vet Med %V 78 %P 339-51 %8 2007 Mar 17 %G eng %N 3-4 %1 http://www.ncbi.nlm.nih.gov/pubmed/17156871?dopt=Abstract %R 10.1016/j.prevetmed.2006.11.001 %0 Journal Article %J Vet Res Commun %D 2006 %T Detection of tetracycline-resistant and susceptible pasteurellaceae in the nasopharynx of loose group-housed calves. %A Boudewijn Catry %A Decostere, A %A Schwarz, S %A Kehrenberg, C %A de Kruif, A %A Haesebrouck, F %K Animals %K Anti-Bacterial Agents %K Cattle %K Cattle Diseases %K Colony Count, Microbial %K Dose-Response Relationship, Drug %K Mannheimia %K Microbial Sensitivity Tests %K Nasopharynx %K Pasteurella %K Pasteurellaceae %K Pasteurellaceae Infections %K prevalence %K Tetracycline Resistance %X

The aim of the present study was to determine which Pasteurella and Mannheimia species are present in the upper respiratory tract of healthy calves with no history of antimicrobial treatment prior to sampling. The presence of subpopulations of tetracycline-resistant Pasteurellaceae was also investigated. Nasal swabs from 61 loose group-housed, clinically healthy calves, 1 to 4 months old, from 16 dairy herds were inoculated aerobically on a selective medium (Columbia agar with 5% ovine blood and 16 mg/L bacitracin) with or without 4 mg/L oxytetracycline (OTC). A total of 43 strains belonging to the family Pasteurellaceae were isolated from 38 calves (62.3%) out of 13 herds (81.3%). The predominant organisms were Pasteurella multocida subsp. multocida (57.4%), Mannheimia varigena (4.9%) and M. haemolytica (3.2%). Growth of Pasteurellaceae on the OTC-containing medium was seen only with samples from two herds (6 animals; 9.8%), and on only one farm this proved to be an OTC-resistant subpopulation. Minimum inhibitory concentration (MIC) determinations by means of agar dilution confirmed a low prevalence of OTC-resistant Pasteurellaceae, with overall MIC(50) and MIC(90) values of 0.25 and 32 mg/L, respectively. These data do not support the hypothesis that the relative high frequency of tetracycline-resistant P. multocida isolates from fatal cases of bovine respiratory disease is related to the presence of minor tetracycline-resistance subpopulations within this species.

%B Vet Res Commun %V 30 %P 707-15 %8 2006 Oct %G eng %N 7 %1 http://www.ncbi.nlm.nih.gov/pubmed/17004035?dopt=Abstract %R 10.1007/s11259-006-3347-8 %0 Journal Article %J J Clin Microbiol %D 2005 %T Fatal peritonitis caused by Pasteurella multocida capsular type F in calves. %A Boudewijn Catry %A Chiers, Koen %A Schwarz, Stefan %A Kehrenberg, Corinna %A Decostere, Annemie %A de Kruif, Aart %K Animals %K Bacterial Capsules %K Cattle %K Cattle Diseases %K Male %K Pasteurella Infections %K Pasteurella multocida %K Peritonitis %X

A fatal case of atypical septicemia of pasteurellosis in veal calves is described. The causative organism was identified as a multiresistant Pasteurella multocida capsular type F isolate. The outbreak was characterized by fibrinous peritonitis and mortality, which are hitherto unreported features of P. multocida capsular type F infections.

%B J Clin Microbiol %V 43 %P 1480-3 %8 2005 Mar %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/15750141?dopt=Abstract %R 10.1128/JCM.43.3.1480-1483.2005 %0 Journal Article %J Res Vet Sci %D 2004 %T Fatal meningitis in a calf caused by Mannheimia varigena. %A Boudewijn Catry %A Opsomer, G %A Decostere, A %A Feyen, B %A de Kruif, A %A Haesebrouck, F %K Animals %K Bacterial Typing Techniques %K Cattle %K Cattle Diseases %K DNA, Bacterial %K Drug Resistance, Microbial %K Fatal Outcome %K Female %K Mannheimia %K Meningitis, Bacterial %K Pasteurellaceae Infections %K polymerase chain reaction %X

Mannheimia varigena was identified as the etiologic agent of meningitis in a young Belgian White Blue heifer calf. Species identification of the bacterium was done by phenotyping and molecularly confirmed by tDNA-PCR. Standard bacteriological examination might fail to differentiate species belonging to the genus Mannheimia.

%B Res Vet Sci %V 77 %P 187-8 %8 2004 Dec %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/15276768?dopt=Abstract %R 10.1016/j.rvsc.2004.04.002 %0 Report %D 0 %T NSIH surveillances: Module du dénominateur et variables communes: protocol 2023 %A Louise Vaes %A Milena Callies %A Katrien Latour %A Karl Mertens %A Isabelle Uwera Mpalirwa %A Nathalie Shodu %A Aline Vilain %A Mariken Vercruyce %A Boudewijn Catry %G eng %0 Report %D 0 %T NSIH surveillances: Noemermodule en gemeenschappelijk gebruikte variabelen: protocol 2023 %A Louise Vaes %A Milena Callies %A Katrien Latour %A Karl Mertens %A Isabelle Uwera Mpalirwa %A Nathalie Shodu %A Aline Vilain %A Mariken Vercruyce %A Boudewijn Catry %G eng %0 Journal Article %D 0 %T Quatrième campagne nationale « Vous êtes en de bonnes mains » : zoom sur les indications « avant contact patient » . NOSO-info 2012; VOL. XVI n° 4, 3-6. %A N. Viseur %A M. Costers %A Karl Mertens %A Boudewijn Catry %A A. Simon %G eng %0 Generic %D 0 %T Symposium - Presentation : National campaigns to promote hand hygiene in Belgian hospitals: A continuous project. « YOU ARE IN GOOD HANDS » - 2016 %A S. Fonguh %A A. Uwineza %A Boudewijn Catry %A A. Simon %G eng %0 Generic %D 0 %T Symposium - Presentation: Vous êtes en de bonnes mains 5ème édition Evolutions et nouveautés - 2013 %A A. Simon %A N. Viseur %A Boudewijn Catry %G eng %0 Generic %D 0 %T Symposium_Presentation : Impact of 10 years multimodal country-wide campaigns to promote hand hygiene in Belgian hospitals « YOU ARE IN GOOD HANDS » - 2016 %A S. Fonguh %A A. Uwineza %A Boudewijn Catry %A A. Simon %G eng %0 Generic %D 0 %T Symposium_Presentation : Multidrug resistant organisms (MDRO): update for Belgium - 2016 %A Boudewijn Catry %A B. Jans %A Karl Mertens %A M-L. Lambert %A Katrien Latour %A A. Ingenbleek %A S. Fonguh %A Els Duysburgh %A C. Valencia %A B. Legiest %A P. Verroens %A A. Uwineza %A N. Verhocht %G eng