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Cimen C, Berends MS, Bathoorn E, Lokate M, Voss A, Friedrich AW, Glasner C, Hamprecht A. Vancomycin-resistant enterococci (VRE) in hospital settings across European borders: a scoping review comparing the epidemiology in the Netherlands and Germany. Antimicrob Resist Infect Control 2023; 12:78. [PMID: 37568229 PMCID: PMC10422769 DOI: 10.1186/s13756-023-01278-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 07/19/2023] [Indexed: 08/13/2023] Open
Abstract
The rising prevalence of vancomycin-resistant enterococci (VRE) is a matter of concern in hospital settings across Europe without a distinct geographical pattern. In this scoping review, we compared the epidemiology of vancomycin-resistant Enterococcus spp. in hospitals in the Netherlands and Germany, between 1991 and 2022. We searched PubMed and summarized the national antibiotic resistance surveillance data of the two countries. We included 46 studies and summarized national surveillance data from the NethMap in the Netherlands, the National Antimicrobial Resistance Surveillance database in Germany, and the EARS-Net data. In total, 12 studies were conducted in hospitals in the Netherlands, 32 were conducted in German hospitals, and an additional two studies were conducted in a cross-border setting. The most significant difference between the two countries was that studies in Germany showed an increasing trend in the prevalence of VRE in hospitals, and no such trend was observed in studies in the Netherlands. Furthermore, in both Dutch and German hospitals, it has been revealed that the molecular epidemiology of VREfm has shifted from a predominance of vanA towards vanB over the years. According to national surveillance reports, vancomycin resistance in Enterococcus faecium clinical isolates fluctuates below 1% in Dutch hospitals, whereas it follows an increasing trend in German hospitals (above 20%), as supported by individual studies. This review demonstrates that VRE is more frequently encountered in German than in Dutch hospitals and discusses the underlying factors for the difference in VRE occurrence in these two neighboring countries by comparing differences in healthcare systems, infection prevention control (IPC) guidelines, and antibiotic use in the Netherlands and Germany.
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Affiliation(s)
- Cansu Cimen
- Institute for Medical Microbiology and Virology, University of Oldenburg, Oldenburg, Germany
- Department of Medical Microbiology and Infection Prevention, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Matthijs S Berends
- Department of Medical Microbiology and Infection Prevention, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Medical Epidemiology, Certe Medical Diagnostics and Advice Foundation, Groningen, The Netherlands
| | - Erik Bathoorn
- Department of Medical Microbiology and Infection Prevention, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Mariëtte Lokate
- Department of Medical Microbiology and Infection Prevention, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Andreas Voss
- Department of Medical Microbiology and Infection Prevention, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Alex W Friedrich
- Department of Medical Microbiology and Infection Prevention, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- University Hospital Muenster, University of Muenster, Muenster, Germany
| | - Corinna Glasner
- Department of Medical Microbiology and Infection Prevention, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
| | - Axel Hamprecht
- Institute for Medical Microbiology and Virology, University of Oldenburg, Oldenburg, Germany
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Tsioutis C, Karageorgos SA. Infection Prevention and Control: Practical and Educational Advances. Trop Med Infect Dis 2022; 7:tropicalmed7080148. [PMID: 35893656 PMCID: PMC9330796 DOI: 10.3390/tropicalmed7080148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 07/25/2022] [Indexed: 12/10/2022] Open
Affiliation(s)
- Constantinos Tsioutis
- School of Medicine, European University Cyprus, Egkomi 2404, Cyprus;
- Correspondence:
| | - Spyridon A. Karageorgos
- School of Medicine, European University Cyprus, Egkomi 2404, Cyprus;
- First Department of Pediatrics, Aghia Sophia Children’s Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece
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Steppert I, Schönfelder J, Schultz C, Kuhlmeier D. Rapid in vitro differentiation of bacteria by ion mobility spectrometry. Appl Microbiol Biotechnol 2021; 105:4297-4307. [PMID: 33974116 PMCID: PMC8140968 DOI: 10.1007/s00253-021-11315-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 04/08/2021] [Accepted: 04/20/2021] [Indexed: 12/03/2022]
Abstract
Rapid screening of infected people plays a crucial role in interrupting infection chains. However, the current methods for identification of bacteria are very tedious and labor intense. Fast on-site screening for pathogens based on volatile organic compounds (VOCs) by ion mobility spectrometry (IMS) could help to differentiate between healthy and potentially infected subjects. As a first step towards this, the feasibility of differentiating between seven different bacteria including resistant strains was assessed using IMS coupled to multicapillary columns (MCC-IMS). The headspace above bacterial cultures was directly drawn and analyzed by MCC-IMS after 90 min of incubation. A cluster analysis software and statistical methods were applied to select discriminative VOC clusters. As a result, 63 VOC clusters were identified, enabling the differentiation between all investigated bacterial strains using canonical discriminant analysis. These 63 clusters were reduced to 7 discriminative VOC clusters by constructing a hierarchical classification tree. Using this tree, all bacteria including resistant strains could be classified with an AUC of 1.0 by receiver-operating characteristic analysis. In conclusion, MCC-IMS is able to differentiate the tested bacterial species, even the non-resistant and their corresponding resistant strains, based on VOC patterns after 90 min of cultivation. Although this result is very promising, in vivo studies need to be performed to investigate if this technology is able to also classify clinical samples. With a short analysis time of 5 min, MCC-IMS is quite attractive for a rapid screening for possible infections in various locations from hospitals to airports. Key Points • Differentiation of bacteria by MCC-IMS is shown after 90-min cultivation. • Non-resistant and resistant strains can be distinguished. • Classification of bacteria is possible based on metabolic features.
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Affiliation(s)
- Isabel Steppert
- MicroDiagnostics, Fraunhofer Institute for Cell Therapy and Immunology IZI, Leipzig, Germany.,Institute for Biochemistry and Biology, University of Potsdam, Potsdam, Germany
| | - Jessy Schönfelder
- MicroDiagnostics, Fraunhofer Institute for Cell Therapy and Immunology IZI, Leipzig, Germany. .,Project Hub Microelectronic and Optical Systems for Biomedicine MEOS, Fraunhofer Institute for Cell Therapy and Immunology IZI, Erfurt, Germany.
| | - Carolyn Schultz
- MicroDiagnostics, Fraunhofer Institute for Cell Therapy and Immunology IZI, Leipzig, Germany
| | - Dirk Kuhlmeier
- MicroDiagnostics, Fraunhofer Institute for Cell Therapy and Immunology IZI, Leipzig, Germany.,Project Hub Microelectronic and Optical Systems for Biomedicine MEOS, Fraunhofer Institute for Cell Therapy and Immunology IZI, Erfurt, Germany
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