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Halonen K, van der Kooi T, Hertogh C, Haenen A, de Greeff SC. Prevalence of healthcare-associated infections in Dutch long-term care facilities from 2009 to 2019. J Hosp Infect 2024; 143:150-159. [PMID: 37321412 DOI: 10.1016/j.jhin.2023.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 06/02/2023] [Accepted: 06/04/2023] [Indexed: 06/17/2023]
Abstract
OBJECTIVE We assessed trends in the prevalence of healthcare-associated infections (HCAIs) and associated resident and facility characteristics in a national network of long-term care facilities (LTCFs) in the Netherlands from 2009 to 2019. METHODS Participating LTCFs registered the prevalence of urinary tract infection (UTI), lower respiratory tract infection (LRTI), gastrointestinal infection (GI), bacterial conjunctivitis, sepsis and skin infection, using standardized definitions, in biannual point-prevalence surveys (PPSs). In addition, resident and LTCF characteristics were collected. Multi-level analyses were performed to study changes in the HCAI prevalence over time and to identify resident and LTCF-related risk factors. Analyses were performed for HCAIs overall and for UTI, LRTI and GI combined as these were recorded throughout the period. RESULTS Overall, 1353 HCAIs were registered in 44,551 residents with a prevalence of 3.0% (95% confidence interval: 2.8-3.1; range between years 2.3-5.1%). When including only UTI, LRTI and GI the prevalence decreased from 5.0% in 2009 to 2.1% in 2019. Multi-variable regression analyses for UTI, LRTI and GI combined indicated that both prolonged participation and calendar time were independently associated with HCAI prevalence; in LTCFs that participated ≥4 years, the HCAI risk was decreased (OR 0.72 (0.57-0.92)) compared with the first year, and the OR per calendar year was 0.93 (0.88-0.97). CONCLUSIONS Over 11 years of PPS in LTCFs the HCAI prevalence decreased over time. Prolonged participation further reduced the HCAI prevalence, in particular UTIs, despite the increasing age and associated frailty of the LTCF population, illustrating the potential value of surveillance.
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Affiliation(s)
- K Halonen
- National Institute for Public Health and the Environment, Centre for Infectious Disease Research, Epidemiology and Surveillance, Bilthoven, the Netherlands.
| | - T van der Kooi
- National Institute for Public Health and the Environment, Centre for Infectious Disease Research, Epidemiology and Surveillance, Bilthoven, the Netherlands
| | - C Hertogh
- Department of Medicine for Older People, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands; Amsterdam Public Health Research Institute, Aging & Later Life, Amsterdam, the Netherlands
| | - A Haenen
- National Institute for Public Health and the Environment, Centre for Infectious Disease Research, Epidemiology and Surveillance, Bilthoven, the Netherlands
| | - S C de Greeff
- National Institute for Public Health and the Environment, Centre for Infectious Disease Research, Epidemiology and Surveillance, Bilthoven, the Netherlands
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Haenen A, Frielink N, van Ool J, Tan FIY, Embregts PJCM. Exploring the experiences of self-determination of individuals with mild intellectual disabilities and epilepsy. J Appl Res Intellect Disabil 2023; 36:1326-1336. [PMID: 37620292 DOI: 10.1111/jar.13151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 07/15/2023] [Accepted: 08/02/2023] [Indexed: 08/26/2023]
Abstract
BACKGROUND While epilepsy can decrease quality of life and self-determination in individuals without intellectual disabilities, the impact of epilepsy on experienced self-determination in people with intellectual disabilities remains unclear. METHOD We conducted semi-structured interviews with six adults (four men, two women) aged 30-61 with mild intellectual disabilities and drug-resistant epilepsy to investigate their experiences of self-determination. The data were analysed using Interpretative Phenomenological Analysis. RESULTS Three main themes were identified: (A) I am a competent person with epilepsy; (B) My social needs: being accepted as I am and stability in relationships; and (C) Being in control. CONCLUSIONS In this study, the impact of epilepsy on experienced self-determination of people with mild intellectual disabilities outweighs the influence of intellectual disabilities. Identity formation, friendships with peers, and autonomy support in risk management are identified as important topics in supporting this group.
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Affiliation(s)
- Alexandra Haenen
- Tranzo, Tilburg School of Social and Behavioural Sciences, Tilburg University, Tilburg, The Netherlands
- Centre for Residential Epilepsy Care, Epilepsy Center Kempenhaeghe, Heeze, The Netherlands
| | - Noud Frielink
- Tranzo, Tilburg School of Social and Behavioural Sciences, Tilburg University, Tilburg, The Netherlands
| | - Jans van Ool
- Centre for Residential Epilepsy Care, Epilepsy Center Kempenhaeghe, Heeze, The Netherlands
| | - Francis I Y Tan
- Centre for Residential Epilepsy Care, Epilepsy Center Kempenhaeghe, Heeze, The Netherlands
| | - Petri J C M Embregts
- Tranzo, Tilburg School of Social and Behavioural Sciences, Tilburg University, Tilburg, The Netherlands
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Lekkerkerk WSN, Haenen A, van der Sande MAB, Leenstra T, de Greeff S, Timen A, Tjon-a-Tsien A, Richardus JH, van de Sande-Bruinsma N, Vos MC. Newly identified risk factors for MRSA carriage in The Netherlands. PLoS One 2017; 12:e0188502. [PMID: 29190731 PMCID: PMC5708665 DOI: 10.1371/journal.pone.0188502] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Accepted: 11/08/2017] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES To elucidate new risk factors for MRSA carriers without known risk factors (MRSA of unknown origin; MUO). These MUO carriers are neither pre-emptively screened nor isolated as normally dictated by the Dutch Search & Destroy policy, thus resulting in policy failure. METHODS We performed a prospective case control study to determine risk factors for MUO acquisition/carriage (Dutch Trial Register: NTR2041). Cases were MUO carriers reported by participating medical microbiological laboratories to the RIVM from September 1st 2011 until September 1st 2013. Controls were randomly selected from the community during this period. RESULTS Significant risk factors for MUO in logistic multivariate analysis were antibiotic use in the last twelve months, aOR 8.1 (5.6-11.7), screened as contact in a contact tracing but not detected as a MRSA carrier at that time, aOR 4.3 (2.1-8.8), having at least one foreign parent, aOR 2.4 (1.4-3.9) and receiving ambulatory care, aOR 2.3 (1.4-3.7). Our found risk factors explained 83% of the MUO carriage. CONCLUSIONS Identifying new risk factors for MRSA carriers remains crucial for countries that apply a targeted screening approach as a Search and Destroy policy or as vertical infection prevention measure.
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Affiliation(s)
- W. S. N. Lekkerkerk
- Department of Medical Microbiology and Infectious Diseases, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- RIVM, National Centre for Health and Environment, Bilthoven, The Netherlands
| | - A. Haenen
- RIVM, National Centre for Health and Environment, Bilthoven, The Netherlands
| | - M. A. B. van der Sande
- RIVM, National Centre for Health and Environment, Bilthoven, The Netherlands
- UMCU, Julius Centre, Utrecht, The Netherlands
- The Institute of Tropical Medicine, Antwerp, Belgium
| | - T. Leenstra
- RIVM, National Centre for Health and Environment, Bilthoven, The Netherlands
| | - S. de Greeff
- RIVM, National Centre for Health and Environment, Bilthoven, The Netherlands
| | - A. Timen
- RIVM, National Centre for Health and Environment, Bilthoven, The Netherlands
| | - A. Tjon-a-Tsien
- Municipal Public Health Service Rotterdam Rijnmond, Rotterdam, The Netherlands
| | - J. H. Richardus
- Municipal Public Health Service Rotterdam Rijnmond, Rotterdam, The Netherlands
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | | | - M. C. Vos
- Department of Medical Microbiology and Infectious Diseases, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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van Duijkeren E, Hengeveld P, Zomer TP, Landman F, Bosch T, Haenen A, van de Giessen A. Transmission of MRSA between humans and animals on duck and turkey farms. J Antimicrob Chemother 2015; 71:58-62. [PMID: 26490016 DOI: 10.1093/jac/dkv313] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Accepted: 08/31/2015] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVES The objectives of this study were to estimate the prevalence of MRSA on duck and turkey farms, identify risk factors for human carriage and study transmission between animals and humans. METHODS On 10 duck and 10 turkey farms, samples were taken from animals, poultry houses, home residences and humans and cultured using pre-enrichment and selective enrichment. MRSA isolates were typed by spa typing and multiple-locus variable number tandem repeat analysis (MLVA) typing. A subset of isolates from animals and humans was investigated using whole-genome mapping. RESULTS MRSA was found on one duck farm and three turkey farms. On duck farms, all humans were MRSA negative. On turkey farms, 5 of 11 farmers, 2 of 32 family members and 15 of 49 samples from the home residences were MRSA positive. Individuals with daily contact with turkeys were significantly more often MRSA positive than individuals without daily contact. All MRSA isolates belonged to livestock-associated MLVA complex 398, belonged to spa type t011, were negative for Panton-Valentine leucocidin, were mecC negative and were mecA positive. Whole-genome mapping proved a valuable tool to study the transmission of livestock-associated MRSA and showed that on two turkey farms the isolates from the animals and humans were indistinguishable or closely related, indicating transmission. CONCLUSIONS MRSA carriage in individuals in daily contact with turkeys was significantly higher than that in individuals only living on the farms or than in the general Dutch population. Therefore, persons with a high degree of contact with turkeys have an increased risk of MRSA carriage, and we propose that they should be screened prior to hospitalization in order to decrease the risk of nosocomial transmission.
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Affiliation(s)
- E van Duijkeren
- Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), PO Box 1, 3720 BA Bilthoven, The Netherlands
| | - P Hengeveld
- Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), PO Box 1, 3720 BA Bilthoven, The Netherlands
| | - T P Zomer
- Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), PO Box 1, 3720 BA Bilthoven, The Netherlands
| | - F Landman
- Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), PO Box 1, 3720 BA Bilthoven, The Netherlands
| | - T Bosch
- Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), PO Box 1, 3720 BA Bilthoven, The Netherlands
| | - A Haenen
- Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), PO Box 1, 3720 BA Bilthoven, The Netherlands
| | - A van de Giessen
- Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), PO Box 1, 3720 BA Bilthoven, The Netherlands
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Halonen K, Haenen A, Smid E, de Greeff S. Surveillance of healthcare associated infections in Dutch nursing homes. Antimicrob Resist Infect Control 2015. [PMCID: PMC4475203 DOI: 10.1186/2047-2994-4-s1-p275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Verhoef L, van der Lubben M, Driesen C, Haenen A, Natsch S, Stobberingh E, de Greeff S. Antibiotic resistance in nursing homes, a real threat? Eur J Public Health 2014. [DOI: 10.1093/eurpub/cku166.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Eilers R, Veldman-Ariesen MJ, Haenen A, van Benthem BH. Prevalence and determinants associated with healthcare-associated infections in long-term care facilities (HALT) in the Netherlands, May to June 2010. Euro Surveill 2012; 17:20252. [PMID: 22939212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
HAIs (healthcare-associated infections) are likely to become an increasing public health problem. Therefore, a point-prevalence study called HALT (Healthcare-associated infections in long-term-care facilities) was set up by the European Centre for Disease Prevention and Control to determine the prevalence, antibiotic use and determinants associated with HAIs. In the Netherlands, 10 nursing homes (in total 1,429 elderly residents) participated in the study between May and June 2010. Risk and protective factors were determined by calculating relative risks (RRs) and performing multilevel Poisson regression. An overall infection prevalence of 2.8% was found and 3.5% of the residents used antibiotics. Residents' characteristics such as the presence of pressure wounds (RR: 2.58; 95% CI:1.04-6.39) and other wounds (RR: 5.70; 95% CI: 2.99-10.86) were risk factors for an HAI, whereas being male (RR: 0.43; 95% CI: 0.21-0.91) was protective. Nursing home characteristics, such as the percentage of shared rooms ( ≥ 2%) (RR: 0.49; 95% CI: 0.39-0.62) and percentage of incontinent residents (≥ 3%) (RR: 0.72; 95% CI: 0.61-0.85) were protective determinants in a multivariate analysis. Special attention is therefore needed for female residents and residents with pressure and other wounds for the prevention of HAIs in Dutch nursing homes.
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Affiliation(s)
- R Eilers
- VU University, Amsterdam, the Netherlands.
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Eilers R, Veldman-Ariesen MJ, Haenen A, van Benthem BH. Prevalence and determinants associated with healthcare-associated infections in long-term care facilities (HALT) in the Netherlands, May to June 2010. Euro Surveill 2012. [DOI: 10.2807/ese.17.34.20252-en] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Binary file ES_Abstracts_Final_ECDC.txt matches
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Affiliation(s)
- R Eilers
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
- VU University, Amsterdam, the Netherlands
| | - M J Veldman-Ariesen
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - A Haenen
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - B H van Benthem
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
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Gruteke P, Haenen A, Scholing M, van Teunenbroek C, de Neeling A. Second MRSA outbreak in a nursing home; role for a super spreader or super sensitive resident. BMC Proc 2011. [PMCID: PMC3239580 DOI: 10.1186/1753-6561-5-s6-p162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Eikelenboom-Boskamp A, Haenen A, Koopmans R, Voss A. EurSafety Health-net: development of an EURegional infection control quality certificate for nursing homes. BMC Proc 2011. [PMCID: PMC3239582 DOI: 10.1186/1753-6561-5-s6-p164] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Lekkerkerk WSN, van de Sande-Bruinsma N, van der Sande MAB, Tjon-A-Tsien A, Groenheide A, Haenen A, Timen A, van den Broek PJ, van Wamel WJB, de Neeling AJ, Richardus JH, Verbrugh HA, Vos MC. Emergence of MRSA of unknown origin in the Netherlands. Clin Microbiol Infect 2011; 18:656-61. [PMID: 21967090 DOI: 10.1111/j.1469-0691.2011.03662.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The Netherlands is known for its low methicillin-resistant Staphylococcus aureus (MRSA) prevalence. Yet MRSA with no link to established Dutch risk factors for acquisition, MRSA of unknown origin (MUO), has now emerged and hampers early detection and control by active screening upon hospital admittance. We assessed the magnitude of the problem and determined the differences between MUO and MRSA of known origin (MKO) for CC398 and non-CC398. National MRSA Surveillance data (2008-2009) were analysed for epidemiological determinants and genotypic characteristics (Panton-Valentine leukocidin, spa). A quarter (24%) of the 5545 MRSA isolates registered were MUO, i.e. not from defined risk groups. There are two genotypic MUO groups: CC398 MUO (352; 26%) and non-CC398 MUO (998; 74%). CC398 MUO needs further investigation because it could suggest spread, not by direct contact with livestock (pigs, veal calves), but through the community. Non-CC398 MUO is less likely to be from a nursing home than non-CC398 MKO (relative risk 0.55; 95% CI 0.42-0.72) and Panton-Valentine leukocidin positivity was more frequent in non-CC398 MUO than MKO (relative risk 1.19; 95% CI 1.11-1.29). Exact transmission routes and risk factors for non-CC398 as CC398 MUO remain undefined.
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Affiliation(s)
- W S N Lekkerkerk
- Department of Medical Microbiology and Infectious Diseases, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands
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Huijsdens XW, Bosch T, van Santen-Verheuvel MG, Spalburg E, Pluister GN, van Luit M, Heck ME, Haenen A, de Neeling AJ. Molecular characterisation of PFGE non-typable methicillin-resistant Staphylococcus aureus in the Netherlands, 2007. Euro Surveill 2009; 14. [DOI: 10.2807/ese.14.38.19335-en] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
In 2007 in the Netherlands, 30% of all human isolates of methicillin-resistant Staphylococcus aureus (MRSA) sent to the National Institute for Public Health and the Environment could not be typed by pulsed-field gel electrophoresis (non-typable (NT)-MRSA). Molecular characterisation of the NT-MRSA isolates revealed 27 different spa types and two distinct SCCmec types, type IV and V. All NT-MRSA isolates were closely related based on spa and multi-locus sequence typing and belonged to the ST398 lineage. The rapid increase of NT-MRSA (ST398) isolates over the last years shows the importance of this relatively new clonal lineage.
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Affiliation(s)
- X W Huijsdens
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - T Bosch
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | | | - E Spalburg
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - G N Pluister
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - M van Luit
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - M E Heck
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - A Haenen
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - A J de Neeling
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
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