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De Baetselier I, Smet H, Kehoe K, Loosen I, Reynders M, Mansoor I, Filippin L, Cauchie M, Van Even E, Makki N, Schiettekatte G, Vandewal W, Glibert B, Matheeussen V, Van der Beken Y, Cartuyvels R, Steyaert S, Lemmens A, Garrino MG, Paridaens H, Lazarova E, Lissoir B, Deffontaine M, Heinrichs A, Saegeman V, Padalko E, Lecompte A, Vanden Berghe W, Kenyon C, Van den Bossche D. Estimation of antimicrobial resistance of Mycoplasma genitalium, Belgium, 2022. Euro Surveill 2024; 29:2300318. [PMID: 38362626 PMCID: PMC10986661 DOI: 10.2807/1560-7917.es.2024.29.7.2300318] [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: 06/21/2023] [Accepted: 08/25/2023] [Indexed: 02/17/2024] Open
Abstract
BackgroundAntimicrobial resistance (AMR) of Mycoplasma genitalium (MG) is a growing concern worldwide and surveillance is needed. In Belgium, samples are sent to the National Reference Centre of Sexually Transmitted Infections (NRC-STI) on a voluntary basis and representative or robust national AMR data are lacking.AimWe aimed to estimate the occurrence of resistant MG in Belgium.MethodsBetween July and November 2022, frozen remnants of MG-positive samples from 21 Belgian laboratories were analysed at the NRC-STI. Macrolide and fluoroquinolone resistance-associated mutations (RAMs) were assessed using Sanger sequencing of the 23SrRNA and parC gene. Differences in resistance patterns were correlated with surveillance methodology, socio-demographic and behavioural variables via Fisher's exact test and logistic regression analysis.ResultsOf the 244 MG-positive samples received, 232 could be sequenced for macrolide and fluoroquinolone RAMs. Over half of the sequenced samples (55.2%) were resistant to macrolides. All sequenced samples from men who have sex with men (MSM) (24/24) were macrolide-resistant. Fluoroquinolone RAMs were found in 25.9% of the samples and occurrence did not differ between socio-demographic and sexual behaviour characteristics.ConclusionAlthough limited in sample size, our data suggest no additional benefit of testing MG retrieved from MSM for macrolide resistance in Belgium, when making treatment decisions. The lower occurrence of macrolide resistance in other population groups, combined with emergence of fluoroquinolone RAMs support macrolide-resistance testing in these groups. Continued surveillance of resistance in MG in different population groups will be crucial to confirm our findings and to guide national testing and treatment strategies.
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Affiliation(s)
- Irith De Baetselier
- National Reference Centre of Sexually Transmitted Infections Belgium, Institute of Tropical Medicine, Department of Clinical Sciences, Antwerp, Belgium
| | - Hilde Smet
- National Reference Centre of Sexually Transmitted Infections Belgium, Institute of Tropical Medicine, Department of Clinical Sciences, Antwerp, Belgium
| | - Kaat Kehoe
- Algemeen Medisch Laboratorium, Antwerp, Belgium
| | | | - Marijke Reynders
- AZ (General Hospital) Sint-Jan Brugge-Oostende AV, Laboratory Medicine, Molecular Microbiology, Bruges, Belgium
| | | | | | | | - Ellen Van Even
- Clinical Laboratory of Microbiology, Heilig Hart (HH) Hospital Lier, Lier, Belgium
| | - Nadia Makki
- Algemeen Medisch Laboratorium, Antwerp, Belgium
| | | | | | | | - Veerle Matheeussen
- Department of Microbiology, University Hospital Antwerp, Edegem, Belgium
| | | | | | | | - Ann Lemmens
- AZ Sint-Maarten Hospital, Department Clinical Microbiology, Mechelen, Belgium
| | | | - Henry Paridaens
- Laboratory of Molecular Biology, Citadelle Hospital, Liege, Belgium
| | - Elena Lazarova
- Clinical laboratory, Regional Hospital de la Haute Senne, Soignies, Belgium
| | | | - Marine Deffontaine
- Laboratoire de Biologie Clinique, Centre Hospitalier de Mouscron, Mouscron, Belgium
| | - Amélie Heinrichs
- Laboratory of Clinical Biology, Hospital Arlon, Vivalia, Arlon, Belgium
| | | | - Elizaveta Padalko
- Ghent University Hospital, Department of Laboratory Medicine, Ghent, Belgium
| | - Amaryl Lecompte
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Wim Vanden Berghe
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Chris Kenyon
- STI Unit, Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Dorien Van den Bossche
- National Reference Centre of Sexually Transmitted Infections Belgium, Institute of Tropical Medicine, Department of Clinical Sciences, Antwerp, Belgium
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2
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D'Onofrio V, Cartuyvels R, Messiaen PEA, Barišić I, Gyssens IC. Virulence Factor Genes in Invasive Escherichia coli Are Associated with Clinical Outcomes and Disease Severity in Patients with Sepsis: A Prospective Observational Cohort Study. Microorganisms 2023; 11:1827. [PMID: 37512999 PMCID: PMC10386379 DOI: 10.3390/microorganisms11071827] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 06/26/2023] [Accepted: 07/15/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Escherichia coli harbours virulence factors that facilitate the development of bloodstream infections. Studies determining virulence factors in clinical isolates often have limited access to clinical data and lack associations with patient outcome. The goal of this study was to correlate sepsis outcome and virulence factors of clinical E. coli isolates in a large cohort. METHODS Patients presenting at the emergency department whose blood cultures were positive for E. coli were prospectively included. Clinical and laboratory parameters were collected at admission. SOFA-score was calculated to determine disease severity. Patient outcomes were in-hospital mortality and ICU admission. Whole genome sequencing was performed for E. coli isolates and virulence genes were detected using the VirulenceFinder database. RESULTS In total, 103 E. coli blood isolates were sequenced. Isolates had six to 41 virulence genes present. One virulence gene, kpsMII_K23, a K1 capsule group 2 of E. coli type K23, was significantly more present in isolates of patients who died. kpsMII_K23 and cvaC (Microcin C) were significantly more frequent in isolates of patients who were admitted to the ICU. Fourteen virulence genes (mchB, mchC, papA_fsiA_F16, sat, senB, iucC, iutA, iha, sfaD, cnf1, focG, vat, cldB, and mcmA) significantly differed between patients with and without sepsis. CONCLUSIONS Microcins, toxins, and fimbriae were associated with disease severity. Adhesins and iron uptake proteins seemed to be protective. Two genes were associated with worse clinical outcome. These findings contribute to a better understanding of host-pathogen interactions and could help identifying patients most at risk for a worse outcome.
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Affiliation(s)
- Valentino D'Onofrio
- Faculty of Medicine and Life Sciences, Hasselt University, Martelarenlaan 42, 3500 Hasselt, Belgium
- Department of Infectious Diseases and Immunity, Jessa Hospital, 3500 Hasselt, Belgium
- Department of Internal Medicine and Radboud, Center for Infectious Diseases, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, The Netherlands
| | | | - Peter E A Messiaen
- Faculty of Medicine and Life Sciences, Hasselt University, Martelarenlaan 42, 3500 Hasselt, Belgium
- Department of Infectious Diseases and Immunity, Jessa Hospital, 3500 Hasselt, Belgium
| | - Ivan Barišić
- Austrian Institute of Technology, 1210 Vienna, Austria
| | - Inge C Gyssens
- Faculty of Medicine and Life Sciences, Hasselt University, Martelarenlaan 42, 3500 Hasselt, Belgium
- Department of Internal Medicine and Radboud, Center for Infectious Diseases, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, The Netherlands
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3
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D'Onofrio V, Heylen D, Pusparum M, Grondman I, Vanwalleghem J, Meersman A, Cartuyvels R, Messiaen P, Joosten LAB, Netea MG, Valkenborg D, Ertaylan G, Gyssens IC. A prospective observational cohort study to identify inflammatory biomarkers for the diagnosis and prognosis of patients with sepsis. J Intensive Care 2022; 10:13. [PMID: 35264246 PMCID: PMC8905560 DOI: 10.1186/s40560-022-00602-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 02/21/2022] [Indexed: 11/24/2022] Open
Abstract
Background Sepsis is a life-threatening organ dysfunction. A fast diagnosis is crucial for patient management. Proteins that are synthesized during the inflammatory response can be used as biomarkers, helping in a rapid clinical assessment or an early diagnosis of infection. The aim of this study was to identify biomarkers of inflammation for the diagnosis and prognosis of infection in patients with suspected sepsis. Methods In total 406 episodes were included in a prospective cohort study. Plasma was collected from all patients with suspected sepsis, for whom blood cultures were drawn, in the emergency department (ED), the department of infectious diseases, or the haemodialysis unit on the first day of a new episode. Samples were analysed using a 92-plex proteomic panel based on a proximity extension assay with oligonucleotide-labelled antibody probe pairs (OLink, Uppsala, Sweden). Supervised and unsupervised differential expression analyses and pathway enrichment analyses were performed to search for inflammatory proteins that were different between patients with viral or bacterial sepsis and between patients with worse or less severe outcome. Results Supervised differential expression analysis revealed 21 proteins that were significantly lower in circulation of patients with viral infections compared to patients with bacterial infections. More strongly, higher expression levels were observed for 38 proteins in patients with high SOFA scores (> 4), and for 21 proteins in patients with worse outcome. These proteins are mostly involved in pathways known to be activated early in the inflammatory response. Unsupervised, hierarchical clustering confirmed that inflammatory response was more strongly related to disease severity than to aetiology. Conclusion Several differentially expressed inflammatory proteins were identified that could be used as biomarkers for sepsis. These proteins are mostly related to disease severity. Within the setting of an emergency department, they could be used for outcome prediction, patient monitoring, and directing diagnostics. Trail registration number: clinicaltrial.gov identifier NCT03841162. Supplementary Information The online version contains supplementary material available at 10.1186/s40560-022-00602-x.
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Affiliation(s)
- Valentino D'Onofrio
- Faculty of Medicine and Life Sciences, Hasselt University, Martelarenlaan 42, 3500, Hasselt, Belgium. .,Department of Infectious Diseases and Immunity, Jessa Hospital, Hasselt, Belgium. .,Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands.
| | - Dries Heylen
- Unit Health, Flemish Institute for Technological Research (VITO), Mol, Belgium.,Data Science Institute, Hasselt University, Hasselt, Belgium
| | - Murih Pusparum
- Unit Health, Flemish Institute for Technological Research (VITO), Mol, Belgium.,Data Science Institute, Hasselt University, Hasselt, Belgium
| | - Inge Grondman
- Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands
| | | | | | | | - Peter Messiaen
- Faculty of Medicine and Life Sciences, Hasselt University, Martelarenlaan 42, 3500, Hasselt, Belgium.,Department of Infectious Diseases and Immunity, Jessa Hospital, Hasselt, Belgium
| | - Leo A B Joosten
- Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands
| | - Mihai G Netea
- Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands.,Human Genomics Laboratory, Craiova University of Medicine and Pharmacy, Craiova, Romania
| | - Dirk Valkenborg
- Data Science Institute, Hasselt University, Hasselt, Belgium
| | - Gökhan Ertaylan
- Unit Health, Flemish Institute for Technological Research (VITO), Mol, Belgium
| | - Inge C Gyssens
- Faculty of Medicine and Life Sciences, Hasselt University, Martelarenlaan 42, 3500, Hasselt, Belgium. .,Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands.
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4
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D'Onofrio V, Keulen L, Vandendriessche A, Dubois J, Cartuyvels R, Vanden Abeele ME, Fraussen J, Vandormael P, Somers V, Achten R, Dendooven A, Driessen A, Augsburg L, Hellings N, Lammens M, Vanrusselt J, Cox J. Studying the clinical, radiological, histological, microbiological, and immunological evolution during the different COVID-19 disease stages using minimal invasive autopsy. Sci Rep 2022; 12:1360. [PMID: 35079048 PMCID: PMC8789771 DOI: 10.1038/s41598-022-05186-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 12/20/2021] [Indexed: 12/12/2022] Open
Abstract
The WHO defines different COVID-19 disease stages in which the pathophysiological mechanisms differ. We evaluated the characteristics of these COVID-19 disease stages. Forty-four PCR-confirmed COVID-19 patients were included in a prospective minimal invasive autopsy cohort. Patients were classified into mild-moderate (n = 4), severe-critical (n = 32) and post-acute disease (n = 8) and clinical, radiological, histological, microbiological and immunological data were compared. Classified according to Thoracic Society of America, patients with mild-moderate disease had no typical COVID-19 images on CT-Thorax versus 71.9% with typical images in severe-critical disease and 87.5% in post-acute disease (P < 0.001). Diffuse alveolar damage was absent in mild-moderate disease but present in 93.8% and 87.5% of patients with severe-critical and post-acute COVID-19 respectively (P = 0.002). Other organs with COVID-19 related histopathological changes were liver and heart. Interferon-γ levels were significantly higher in patients with severe-critical COVID-19 (P = 0.046). Anti-SARS CoV-2 IgG was positive in 66%, 40.6% and 87.5% of patients with mild-moderate, severe-critical and post-acute COVID-19 respectively (n.s.). Significant differences in histopathological and immunological characteristics between patients with mild-moderate disease compared to patients with severe-critical disease were found, whereas differences between patients with severe-critical disease and post-acute disease were limited. This emphasizes the need for tailored treatment of COVID-19 patients.
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Affiliation(s)
- Valentino D'Onofrio
- Department of Immunology and Infection, Faculty of Medicine and Life Sciences, Hasselt University, Martelarenlaan 42, 3500, Hasselt, Belgium. .,Department of Infectious Diseases and Immunity, Jessa Hospital, Stadsomvaart 11, 3500, Hasselt, Belgium.
| | - Lotte Keulen
- Department of Pathology, Antwerp University Hospital, Edegem, Belgium
| | | | - Jasperina Dubois
- Intensive Care and Anesthesiology, Jessa Hospital, Hasselt, Belgium
| | | | | | - Judith Fraussen
- Department of Immunology and Infection, Faculty of Medicine and Life Sciences, Hasselt University, Martelarenlaan 42, 3500, Hasselt, Belgium
| | - Patrick Vandormael
- Department of Immunology and Infection, Faculty of Medicine and Life Sciences, Hasselt University, Martelarenlaan 42, 3500, Hasselt, Belgium
| | - Veerle Somers
- Department of Immunology and Infection, Faculty of Medicine and Life Sciences, Hasselt University, Martelarenlaan 42, 3500, Hasselt, Belgium
| | - Ruth Achten
- Department of Pathology, Jessa Hospital, Hasselt, Belgium.,Core, University of Antwerp, Wilrijk, Belgium
| | - Amélie Dendooven
- Department of Pathology, Antwerp University Hospital, Edegem, Belgium.,Core, University of Antwerp, Wilrijk, Belgium.,Department of Pathology, University Hospital Ghent, Ghent, Belgium
| | - Ann Driessen
- Department of Pathology, Antwerp University Hospital, Edegem, Belgium.,Core, University of Antwerp, Wilrijk, Belgium
| | | | - Niels Hellings
- Department of Immunology and Infection, Faculty of Medicine and Life Sciences, Hasselt University, Martelarenlaan 42, 3500, Hasselt, Belgium
| | - Martin Lammens
- Department of Pathology, Antwerp University Hospital, Edegem, Belgium.,Core, University of Antwerp, Wilrijk, Belgium
| | - Jan Vanrusselt
- Department of Radiology, Jessa Hospital, Hasselt, Belgium
| | - Janneke Cox
- Department of Immunology and Infection, Faculty of Medicine and Life Sciences, Hasselt University, Martelarenlaan 42, 3500, Hasselt, Belgium. .,Department of Infectious Diseases and Immunity, Jessa Hospital, Stadsomvaart 11, 3500, Hasselt, Belgium.
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5
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Gruwier L, Sprenkels A, Hulsbosch S, Vankeerberghen A, Cartuyvels R. Sneathia amnii bacteraemia and chorioamnionitis leading to second trimester abortion: a case report. Access Microbiol 2021; 3:000290. [PMID: 35024552 PMCID: PMC8749150 DOI: 10.1099/acmi.0.000290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 10/20/2021] [Indexed: 11/18/2022] Open
Abstract
Background Sneathia amnii (formerly designated as Leptotrichia amnionii) was first described in 2002 in the USA. Members of the genus Sneathia can be part of the normal flora of the genitourinary tract, but have been implicated in invasive (mostly gynaecological) infections. Case presentation To the best of our knowledge, here we present the first case of S. amnii infection in Belgium, in a young woman presenting with fever leading to second trimester septic abortion. Conclusion Despite its pathogenicity, S. amnii remains an underrated cause of infections due to inherent difficulties with conventional laboratory methods. By extracting the bacterial DNA directly from the blood culture broth and performing a 16S ribosomal RNA gene sequence analysis we succeeded in identifying S. amnii as the most probable cause of the septic abortion in our patient.
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Affiliation(s)
- Lien Gruwier
- Jessa Hospital, Laboratory of Clinical Microbiology, Hasselt, Belgium
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6
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Heireman L, Abrams S, Bruynseels P, Cartuyvels R, Cuypers L, De Schouwer P, Laffut W, Lagrou K, Hens N, Ho E, Padalko E, Reynders M, Vandamme S, Van der Moeren N, Verstrepen W, Willems P, Naesens R. Evaluation of the SARS-CoV-2 positivity ratio and upper respiratory tract viral load among asymptomatic individuals screened before hospitalization or surgery in Flanders, Belgium. PLoS One 2021; 16:e0259908. [PMID: 34762704 PMCID: PMC8584712 DOI: 10.1371/journal.pone.0259908] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 10/28/2021] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION The incidence of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infections in the Belgian community is mainly estimated based on test results of patients with coronavirus disease (COVID-19)-like symptoms. The aim of this study was to investigate the evolution of the SARS-CoV-2 reverse transcriptase polymerase chain reaction (RT-PCR) positivity ratio and distribution of viral loads within a cohort of asymptomatic patients screened prior hospitalization or surgery, stratified by age category. MATERIALS/METHODS We retrospectively studied data on SARS-CoV-2 real-time RT-PCR detection in respiratory tract samples of asymptomatic patients screened pre-hospitalization or pre-surgery in nine Belgian hospitals located in Flanders over a 12-month period (1 April 2020-31 March 2021). RESULTS In total, 255925 SARS-CoV-2 RT-PCR test results and 2421 positive results for which a viral load was reported, were included in this study. An unweighted overall SARS-CoV-2 real-time RT-PCR positivity ratio of 1.27% was observed with strong spatiotemporal differences. SARS-CoV-2 circulated predominantly in 80+ year old individuals across all time periods except between the first and second COVID-19 wave and in 20-30 year old individuals before the second COVID-19 wave. In contrast to the first wave, a significantly higher positivity ratio was observed for the 20-40 age group in addition to the 80+ age group compared to the other age groups during the second wave. The median viral load follows a similar temporal evolution as the positivity rate with an increase ahead of the second wave and highest viral loads observed for 80+ year old individuals. CONCLUSION There was a high SARS-CoV-2 circulation among asymptomatic patients with a predominance and highest viral loads observed in the elderly. Moreover, ahead of the second COVID-19 wave an increase in median viral load was noted with the highest overall positivity ratio observed in 20-30 year old individuals, indicating they could have been the hidden drivers of this wave.
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Affiliation(s)
- Laura Heireman
- Department of Laboratory Medicine, ZiekenhuisNetwerk Antwerpen, Antwerp, Belgium
| | - Steven Abrams
- Data Science Institute, Interuniversity Institute for Biostatistics and statistical Bioinformatics (I-BioStat), UHasselt, Hasselt, Belgium
- Global Health Institute, Family Medicine and Population Health, University of Antwerp, Antwerp, Belgium
| | - Peggy Bruynseels
- Department of Laboratory Medicine, ZiekenhuisNetwerk Antwerpen, Antwerp, Belgium
| | | | - Lize Cuypers
- Department of Laboratory Medicine and National Reference Center for Respiratory Pathogens, University Hospitals Leuven, Leuven, Belgium
| | - Pieter De Schouwer
- Department of Laboratory Medicine, ZiekenhuisNetwerk Antwerpen, Antwerp, Belgium
| | - Wim Laffut
- Department of Laboratory Medicine, Heilig Hart Hospital, Lier, Belgium
| | - Katrien Lagrou
- Department of Laboratory Medicine and National Reference Center for Respiratory Pathogens, University Hospitals Leuven, Leuven, Belgium
| | - Niel Hens
- Data Science Institute, Interuniversity Institute for Biostatistics and statistical Bioinformatics (I-BioStat), UHasselt, Hasselt, Belgium
- Centre for Health Economic Research and Modelling Infectious Diseases, University of Antwerp, Antwerp, Belgium
| | - Erwin Ho
- Department of Laboratory Medicine, Sint-Maarten Hospital, Mechelen, Belgium
| | - Elizaveta Padalko
- Department of Laboratory Medicine, University Hospital Ghent, Ghent, Belgium
| | - Marijke Reynders
- Department of Laboratory Medicine, Sint-Jan Hospital, Bruges, Belgium
| | - Sarah Vandamme
- Department of Laboratory Medicine, Antwerp University Hospital, Antwerp, Belgium
| | | | - Walter Verstrepen
- Department of Laboratory Medicine, ZiekenhuisNetwerk Antwerpen, Antwerp, Belgium
| | - Philippe Willems
- Department of Laboratory Medicine GasthuisZusters Antwerpen, Antwerp, Belgium
| | - Reinout Naesens
- Department of Laboratory Medicine, ZiekenhuisNetwerk Antwerpen, Antwerp, Belgium
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Maelegheer K, Reynders M, Floré K, Vanacker J, Vanlaere E, Cartuyvels R, Raymaekers M. Multicenter evaluation of the FilmArray Meningitis/Encephalitis assay in a routine setting. J Med Microbiol 2021; 70. [PMID: 34665115 DOI: 10.1099/jmm.0.001438] [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] [Indexed: 11/18/2022] Open
Abstract
Introduction. The FilmArray Meningitis/Encephalitis (FA-ME) Panel (Biofire, Salt Lake City, Utah, US) enables fast and automated detection of 14 pathogens in cerebrospinal fluid (CSF).Gap statement. The performance of the FA-ME panel in a real routine setting has not yet been described and could lead to better patient management in cases of good performance.Aim. This multicenter study verified the FA-ME panel analytical performance in a routine hospital setting.Methodology. Between April 2016 and April 2018, 454 CSF samples were analysed with the FA-ME panel and compared with routine diagnostics. In cases of discrepancy or lack of a comparator result, a profound analysis based on patient records and other laboratory results was performed.Results. A first analysis of 65 frozen samples, suspicious for meningitis had a 89 % concordance with routine diagnostics. The limit of detection (LOD) was confirmed for all pathogens except for Streptococcus agalactiae and a strain of Haemophilus influenzae (Escherichia coli K1 and Cryptococcus gattii LOD experiments were not performed). The routine evaluation showed a positive result in 114 (25 %) clinical samples for at least one target. In three samples co-infections were found. After discrepancy analysis, overall sensitivity was 98 % (false negative FA-ME results for one HSV2, two HSV1 and two parechovirus). Four FA-ME results were considered false positive (two HHV6, one VZV and one E. coli K1), resulting in an overall specificity of >99 %. A clinical added value of the assay was seen in the diagnosis of eight cases of bacterial meningitis.Conclusion. Because of its rapidity and ease of use, the FA-ME panel has great potential in the diagnosis of central nervous infections. Implementation can improve clinical management, but costs and analytical limitations need to be addressed to convince clinicians and laboratories of its value.
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Affiliation(s)
- Karel Maelegheer
- Laboratory Medicine, Medical Microbiology, AZ Sint Lucas, Sint Lucaslaan 29, B-8310 Brugge, Belgium
| | - Marijke Reynders
- Laboratory Medicine, Medical Microbiology, AZ Sint-Jan, Ruddershove 10, B-8000 Brugge, Belgium
| | - Katelijne Floré
- Laboratory Medicine, Medical Microbiology, AZ Sint-Jan, Ruddershove 10, B-8000 Brugge, Belgium
| | - Jos Vanacker
- Laboratory Medicine, Medical Microbiology, AZ Sint Lucas, Groenebriel 1, B-9000 Gent, Belgium
| | - Elke Vanlaere
- Laboratory Medicine, Medical Microbiology, AZ Sint Lucas, Groenebriel 1, B-9000 Gent, Belgium
| | - Reinoud Cartuyvels
- Clinical Biology, Laboratory for Molecular Diagnostics, Jessa Hospital, Salvatorstraat 20, 3500 Hasselt, Belgium
| | - Marijke Raymaekers
- Clinical Biology, Laboratory for Molecular Diagnostics, Jessa Hospital, Salvatorstraat 20, 3500 Hasselt, Belgium
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8
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Boeckmans J, Rombaut M, Demuyser T, Declerck B, Piérard D, Rogiers V, De Kock J, Waumans L, Magerman K, Cartuyvels R, Rummens JL, Rodrigues RM, Vanhaecke T. Infections at the nexus of metabolic-associated fatty liver disease. Arch Toxicol 2021; 95:2235-2253. [PMID: 34027561 PMCID: PMC8141380 DOI: 10.1007/s00204-021-03069-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 04/29/2021] [Indexed: 02/07/2023]
Abstract
Metabolic-associated fatty liver disease (MAFLD) is a chronic liver disease that affects about a quarter of the world population. MAFLD encompasses different disease stadia ranging from isolated liver steatosis to non-alcoholic steatohepatitis (NASH), fibrosis, cirrhosis and hepatocellular carcinoma. Although MAFLD is considered as the hepatic manifestation of the metabolic syndrome, multiple concomitant disease-potentiating factors can accelerate disease progression. Among these risk factors are diet, lifestyle, genetic traits, intake of steatogenic drugs, male gender and particular infections. Although infections often outweigh the development of fatty liver disease, pre-existing MAFLD could be triggered to progress towards more severe disease stadia. These combined disease cases might be underreported because of the high prevalence of both MAFLD and infectious diseases that can promote or exacerbate fatty liver disease development. In this review, we portray the molecular and cellular mechanisms by which the most relevant viral, bacterial and parasitic infections influence the progression of fatty liver disease and steatohepatitis. We focus in particular on how infectious diseases, including coronavirus disease-19, hepatitis C, acquired immunodeficiency syndrome, peptic ulcer and periodontitis, exacerbate MAFLD. We specifically underscore the synergistic effects of these infections with other MAFLD-promoting factors.
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Affiliation(s)
- Joost Boeckmans
- Department of In Vitro Toxicology and Dermato-Cosmetology, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium.
- Clinical Laboratory, Jessa Hospital, Stadsomvaart 11, 3500, Hasselt, Belgium.
| | - Matthias Rombaut
- Department of In Vitro Toxicology and Dermato-Cosmetology, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium
| | - Thomas Demuyser
- Department of Microbiology, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium
- Center for Neurosciences, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium
| | - Baptist Declerck
- Department of Microbiology, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium
| | - Denis Piérard
- Department of Microbiology, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium
| | - Vera Rogiers
- Department of In Vitro Toxicology and Dermato-Cosmetology, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium
| | - Joery De Kock
- Department of In Vitro Toxicology and Dermato-Cosmetology, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium
| | - Luc Waumans
- Clinical Laboratory, Jessa Hospital, Stadsomvaart 11, 3500, Hasselt, Belgium
| | - Koen Magerman
- Clinical Laboratory, Jessa Hospital, Stadsomvaart 11, 3500, Hasselt, Belgium
- Department of Immunology and Infection, Hasselt University, Martelarenlaan 42, 3500, Hasselt, Belgium
| | - Reinoud Cartuyvels
- Clinical Laboratory, Jessa Hospital, Stadsomvaart 11, 3500, Hasselt, Belgium
| | - Jean-Luc Rummens
- Clinical Laboratory, Jessa Hospital, Stadsomvaart 11, 3500, Hasselt, Belgium
| | - Robim M Rodrigues
- Department of In Vitro Toxicology and Dermato-Cosmetology, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium.
| | - Tamara Vanhaecke
- Department of In Vitro Toxicology and Dermato-Cosmetology, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium
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9
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D'Onofrio V, Meersman A, Magerman K, Waumans L, van Halem K, Cox JA, van der Hilst JC, Cartuyvels R, Messiaen P, Gyssens IC. Audit of empirical antibiotic therapy for sepsis and the impact of early multidisciplinary consultation on patient outcomes. Int J Antimicrob Agents 2021; 58:106379. [PMID: 34161787 DOI: 10.1016/j.ijantimicag.2021.106379] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 10/20/2020] [Revised: 04/04/2021] [Accepted: 06/13/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To perform an audit of empirical antibiotic therapy (EAT) of sepsis at the emergency department and to analyse the impact of an antimicrobial stewardship (AMS) programme on process and patient outcomes. PATIENTS AND METHODS A prospective, single-centre cohort study including patients with sequential organ failure assessment (SOFA) score ≥2 from whom blood cultures were taken was conducted between February 2019 and April 2020. EAT was assessed using eight applicable inpatient quality indicators (IQIs) for responsible antibiotic use. Patient outcomes were hospital length-of-stay (LOS), ICU admission, ICU LOS, and in-hospital mortality. RESULTS The audit included 900 sepsis episodes in 803 patients. Full guideline adherence regarding choice and dosing was 45.9%; adherence regarding choice alone was 68.1%. EAT was active against all likely pathogens in 665/787 (84.5%) episodes. In the guideline non-adherent group, choice of EAT was inappropriate in 122/251 (48.6%) episodes. Changes within 3 days occurred in 335/900 (37.2%) episodes. Treating physicians changed administration route more often, whereas microbiological/infectious disease (ID)/AMS consultant advice resulted in de-escalation and discontinuation (P = 0.000). Guideline-adherent choice was associated with significantly shorter LOS (6 (4-11) vs. 8 (5-15) days). Full adherence was associated with significantly lower mortality (23 (6.4%) vs. 48 (11.3%)) and shorter LOS (6 (4-10) vs. 8 (5-14) days). CONCLUSION Five global quality indicators of EAT were measurable in routine clinical practice. Full adherence to guidelines was only moderate. Adherence to guidelines was associated with better patient outcomes.
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Affiliation(s)
- Valentino D'Onofrio
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium; Department of Infectious Diseases and Immunity, Jessa Hospital, Hasselt, Belgium; Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Koen Magerman
- Department of Clinical Biology, Jessa Hospital, Hasselt, Belgium
| | - Luc Waumans
- Department of Clinical Biology, Jessa Hospital, Hasselt, Belgium
| | - Karlijn van Halem
- Department of Infectious Diseases and Immunity, Jessa Hospital, Hasselt, Belgium
| | - Janneke A Cox
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium; Department of Infectious Diseases and Immunity, Jessa Hospital, Hasselt, Belgium
| | - Jeroen C van der Hilst
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium; Department of Infectious Diseases and Immunity, Jessa Hospital, Hasselt, Belgium
| | | | - Peter Messiaen
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium; Department of Infectious Diseases and Immunity, Jessa Hospital, Hasselt, Belgium
| | - Inge C Gyssens
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium; Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands.
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10
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Boeckmans J, Cartuyvels R, Hilkens P, Bruckers L, Magerman K, Waumans L, Raymaekers M. Follow-up testing of borderline SARS-CoV-2 patients by rRT-PCR allows early diagnosis of COVID-19. Diagn Microbiol Infect Dis 2021; 100:115350. [PMID: 33689985 PMCID: PMC7891066 DOI: 10.1016/j.diagmicrobio.2021.115350] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 02/08/2021] [Accepted: 02/13/2021] [Indexed: 01/05/2023]
Abstract
Detection of SARS-CoV-2 RNA in nasopharyngeal samples using the real-time reverse transcription polymerase chain reaction (rRT-PCR) is the gold standard for diagnosing COVID-19. Determination of SARS-CoV-2 RNA by rRT-PCR sometimes results in an inconclusive test result due to a high cycle threshold-value. We retrospectively analyzed 30,851 SARS-CoV-2 rRT-PCR test results. Borderline positivity was considered as the presence of ≤25 viral copies per milliliter, while no amplification was considered as a negative test result. Of all test results, 204 were answered as borderline, of which 107 were accompanied by a follow-up test within 96 hours. Of the 107 follow-up samples, 10 (9.35%) were found positive for SARS-CoV-2. COVID-19 symptoms were not predictive for testing positive in the follow-up test. The positive SARS-CoV-2 samples in the follow-up group represented 0.92% of all positive test results, highlighting the need for retesting and increased hygienic measures for borderline SARS-CoV-2 patients [NCT04636294].
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Affiliation(s)
| | | | - Petra Hilkens
- Clinical Laboratory, Jessa Hospital, Hasselt, Belgium
| | - Liesbeth Bruckers
- I-BioStat, Data Science Institute, Hasselt University, Hasselt, Belgium
| | - Koen Magerman
- Clinical Laboratory, Jessa Hospital, Hasselt, Belgium; Immunity and Infectious Diseases, Hasselt University, Hasselt, Belgium
| | - Luc Waumans
- Clinical Laboratory, Jessa Hospital, Hasselt, Belgium
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11
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Van Loon N, Verbrugghe M, Cartuyvels R, Ramaekers D. Diagnosis of COVID-19 Based on Symptomatic Analysis of Hospital Healthcare Workers in Belgium: Observational Study in a Large Belgian Tertiary Care Center During Early COVID-19 Outbreak. J Occup Environ Med 2021; 63:27-31. [PMID: 32858554 PMCID: PMC7773160 DOI: 10.1097/jom.0000000000002015] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To identify early symptoms allowing rapid appraisal of infection with SARS-CoV-2 among healthcare workers of a large Belgian hospital. METHODS Healthcare workers with mild symptoms of an acute respiratory tract infection were systematically screened on clinical characteristics of corona virus disease 2019 (COVID-19). A nasopharyngeal swab was taken and analyzed by real-time Reverse-Transcription-Polymerase-Chain-Reaction (rRT-PCR). RESULTS Fifty percent of 373 workers tested COVID-19 positive. The symptoms cough (82%), headache (78%), myalgia (70%), loss of smell or taste (40%), and fever more than or equal to 37.5 °C (76%) were significantly higher among those infected. CONCLUSION Where each individual symptom contributes to the clinical evaluation of possible infection, it is the combination of COVID-19 symptoms that could allow for a rapid diagnostic appraisal of the disease in a high prevalence setting. Early transmission control is important at the onset of an epidemic.
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Affiliation(s)
- Nele Van Loon
- Mensura, Occupational Health Service (OHS), Brussels (Dr Van Loon, Dr Verbrugghe); Department of Public Health and Primary Care, University of Ghent, Ghent (Dr Verbrugghe); Jessa Hospital, Hasselt (Dr Cartuyvels, Dr Ramaekers); Leuven Institute for Healthcare Policy (LIHP), University of Leuven, Leuven (Dr Ramaekers), Belgium
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12
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D'Onofrio V, Meersman A, Vijgen S, Cartuyvels R, Messiaen P, Gyssens IC. Risk Factors for Mortality, Intensive Care Unit Admission, and Bacteremia in Patients Suspected of Sepsis at the Emergency Department: A Prospective Cohort Study. Open Forum Infect Dis 2020; 8:ofaa594. [PMID: 33511231 PMCID: PMC7813192 DOI: 10.1093/ofid/ofaa594] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 12/03/2020] [Indexed: 12/31/2022] Open
Abstract
Background There is a clear need for a better assessment of independent risk factors for in-hospital mortality, intensive care unit admission, and bacteremia in patients presenting with suspected sepsis at the emergency department. Methods A prospective observational cohort study including 1690 patients was performed. Two multivariable logistic regression models were used to identify independent risk factors. Results Sequential organ failure assessment (SOFA) score of ≥2 and serum lactate of ≥2mmol/L were associated with all outcomes. Other independent risk factors were individual SOFA variables and systemic inflammatory response syndrome variables but varied per outcome. Mean arterial pressure <70 mmHg negatively impacted all outcomes. Conclusions These readily available measurements can help with early risk stratification and prediction of prognosis.
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Affiliation(s)
- Valentino D'Onofrio
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium.,Department of Infectious Diseases and Immunity, Jessa Hospital, Hasselt, Belgium.,Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, the Netherlands
| | | | - Sara Vijgen
- Clinical Laboratory, Jessa Hospital, Hasselt, Belgium
| | | | - Peter Messiaen
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium.,Department of Infectious Diseases and Immunity, Jessa Hospital, Hasselt, Belgium
| | - Inge C Gyssens
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium.,Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, the Netherlands
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13
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D’Onofrio V, Donders E, Vanden Abeele ME, Dubois J, Cartuyvels R, Achten R, Lammens M, Dendooven A, Driessen A, Augsburg L, Vanrusselt J, Cox J. The clinical value of minimal invasive autopsy in COVID-19 patients. PLoS One 2020; 15:e0242300. [PMID: 33175911 PMCID: PMC7657516 DOI: 10.1371/journal.pone.0242300] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 11/02/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Minimally invasive autopsy (MIA) is a validated and safe method to establish the cause of death (COD), mainly in low-resource settings. However, the additional clinical value of MIA in Coronavirus disease (COVID-19) patients in a high-resource setting is unknown. The objective was to assess if and how MIA changed clinical COD and contributing diagnoses in deceased COVID-19 patients. METHODS AND FINDINGS A prospective observational cohort from April to May 2020 in a 981-bed teaching hospital in the epicenter of the COVID-19 pandemic in Belgium was established. Patients who died with either PCR-confirmed or radiologically confirmed COVID-19 infection were consecutively included. MIA consisted of whole-body CT and CT-guided Tru-Cut® biopsies. Diagnostic modalities were clinical chart review, radiology, microbiology, and histopathology which were assessed by two independent experts per modality. MIA COD and contributing diagnoses were established during a multi-disciplinary meeting. Clinical COD (CCOD) and contributing diagnosis were abstracted from the discharge letter. The main outcomes were alterations in CCOD and contributing diagnoses after MIA, and the contribution of each diagnostic modality. We included 18 patients, of which 7 after intensive care unit hospitalization. MIA led to an alteration in 15/18 (83%) patients. The CCOD was altered in 5/18 (28%) patients. MIA found a new COD (1/5), a more specific COD (1/5), a less certain COD (1/5), or a contributing diagnosis to be the COD (2/5). Contributing diagnoses were altered in 14/18 (78%) patients: 9 new diagnoses, 5 diagnoses dismissed, 3 made more specific, and 2 made less certain. Overall, histopathology contributed in 14/15 (93%) patients with alterations, radiology and microbiology each in 6/15 (40%), and clinical review in 3/15 (20%). Histopathology was deemed the most important modality in 10 patients, radiology in two patients, and microbiology in one patient. CONCLUSION MIA, especially histological examination, can add valuable new clinical information regarding the cause of death in COVID-19 patients, even in a high-resource setting with wide access to premortem diagnostic modalities. MIA may provide important clinical insights and should be applied in the current ongoing pandemic. TRIAL REGISTRATION Clinicaltrials.gov identifier: NCT04366882.
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Affiliation(s)
- Valentino D’Onofrio
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
- Department of Infectious Diseases and Immunity, Jessa Hospital, Hasselt, Belgium
| | - Elena Donders
- Department of Infectious Diseases and Immunity, Jessa Hospital, Hasselt, Belgium
| | | | - Jasperina Dubois
- Intensive Care and Anesthesiology, Jessa Hospital, Hasselt, Belgium
| | | | - Ruth Achten
- Department of Pathology, Jessa Hospital, Hasselt, Belgium
- Department of Pathology, Antwerp University Hospital, Edegem, Belgium
| | - Martin Lammens
- Department of Pathology, Antwerp University Hospital, Edegem, Belgium
- Core, University of Antwerp, Wilrijk, Belgium
| | - Amelie Dendooven
- Department of Pathology, Antwerp University Hospital, Edegem, Belgium
- Core, University of Antwerp, Wilrijk, Belgium
- Department of Pathology, University Hospital Ghent, Ghent, Belgium
| | - Ann Driessen
- Department of Pathology, Antwerp University Hospital, Edegem, Belgium
- Core, University of Antwerp, Wilrijk, Belgium
| | | | - Jan Vanrusselt
- Department of Radiology, Jessa Hospital, Hasselt, Belgium
| | - Janneke Cox
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
- Department of Infectious Diseases and Immunity, Jessa Hospital, Hasselt, Belgium
- * E-mail:
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14
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D'Onofrio V, Salimans L, Bedenić B, Cartuyvels R, Barišić I, Gyssens IC. The Clinical Impact of Rapid Molecular Microbiological Diagnostics for Pathogen and Resistance Gene Identification in Patients With Sepsis: A Systematic Review. Open Forum Infect Dis 2020; 7:ofaa352. [PMID: 33033730 PMCID: PMC7528559 DOI: 10.1093/ofid/ofaa352] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 08/10/2020] [Indexed: 12/12/2022] Open
Abstract
Fast microbiological diagnostics (MDx) are needed to ensure early targeted antimicrobial treatment in sepsis. This systematic review focuses on the impact on antimicrobial management and patient outcomes of MDx for pathogen and resistance gene identification compared with blood cultures. PubMed was searched for clinical studies using either whole blood directly or after short-term incubation. Twenty-five articles were retrieved describing the outcomes of 8 different MDx. Three interventional studies showed a significant increase in appropriateness of antimicrobial therapy and a nonsignificant change in time to appropriate therapy. Impact on mortality was conflicting. Length of stay was significantly lower in 2 studies. A significant decrease in antimicrobial cost was demonstrated in 6 studies. The limitations of this systematic review include the low number and observed heterogeneity of clinical studies. In conclusion, potential benefits of MDx regarding antimicrobial management and some patient outcomes were reported. More rigorous intervention studies are needed focusing on the direct benefits for patients.
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Affiliation(s)
- Valentino D'Onofrio
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium.,Department of Infectious Diseases and Immunity, Jessa Hospital, Hasselt, Belgium.,Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Lene Salimans
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
| | - Branka Bedenić
- Department of Microbiology, School of Medicine, University of Zagreb, Zagreb, Croatia
| | | | - Ivan Barišić
- Molecular diagnostics, Austrian Institute of Technology, Vienna, Austria
| | - Inge C Gyssens
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium.,Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, the Netherlands
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15
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Pulinx B, Kieffer D, Michiels I, Petermans S, Strybol D, Delvaux S, Baldewijns M, Raymaekers M, Cartuyvels R, Maurissen W. Vertical transmission of SARS-CoV-2 infection and preterm birth. Eur J Clin Microbiol Infect Dis 2020; 39:2441-2445. [PMID: 32661809 PMCID: PMC7357443 DOI: 10.1007/s10096-020-03964-y] [Citation(s) in RCA: 74] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 06/24/2020] [Indexed: 12/19/2022]
Abstract
Viral infections are common complications of pregnancy, with a wide range of obstetric and neonatal sequelae. Currently, there are limited data on whether SARS-CoV-2 is vertically transmitted in pregnant women tested positive for the virus. Here we describe a case of a known SARS-CoV-2-positive woman giving preterm birth to two fetuses with SARS-CoV-2 positive testing in placental tissue and amniotic fluid. The placental histological examinations showed chronic intervillositis and extensive intervillous fibrin depositions with ischemic necrosis of the surrounding villi.
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Affiliation(s)
- Bianca Pulinx
- Department of Clinical Biology, Sint-Trudo Hospital, Diestersteenweg 100, 3800, Sint-Truiden, Belgium
| | - Davy Kieffer
- Department of Clinical Biology, Sint-Trudo Hospital, Diestersteenweg 100, 3800, Sint-Truiden, Belgium
| | - Ian Michiels
- Department of Gynaecology, Sint-Trudo Hospital, Sint-Truiden, Belgium
| | | | - David Strybol
- Department of Pathology, Sint-Trudo Hospital, Sint-Truiden, Belgium
| | - Sigrun Delvaux
- Department of Pathology, Sint-Trudo Hospital, Sint-Truiden, Belgium
| | | | | | | | - Wim Maurissen
- Department of Clinical Biology, Sint-Trudo Hospital, Diestersteenweg 100, 3800, Sint-Truiden, Belgium.
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16
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van Halem K, Cox J, Messiaen P, Pat K, Declercq C, Meersman A, Ramaekers D, Cartuyvels R, van der Hilst J. Care for adult non-ICU Covid-19 patients: early experiences from a Belgian tertiary care centre. Neth J Med 2020; 78:111-115. [PMID: 32332185] [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: 06/11/2023]
Abstract
The current Covid-19 outbreak poses many challenges on hospital organisation and patient care. Our hospital lies at the epicentre of the Belgian epidemic. On April 1st, a total of 235 Covid-19 patients had been admitted to our hospital. This demanded an unprecedented adaptation of our hospital organisation, and we have met many clinical issues in the care for Covid-19 patients. In this article, we share our experience in the handling of some of the practical and organisational issues in the care for Covid-19 patients.
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Affiliation(s)
- K van Halem
- Department of Infectious Diseases and Immunity, Jessa Hospital, Hasselt Belgium
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17
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Baten E, Van Der Aa F, Orye C, Cartuyvels R, Arijs I, van Renterghem K. Antibiotic prophylaxis in TURP: a prospective analysis concerning antibiotic stewardship and a potential reduction of antibiotic use in TURP. World J Urol 2019; 37:2467-2472. [DOI: 10.1007/s00345-019-02676-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 02/05/2019] [Indexed: 11/30/2022] Open
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18
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Van Besien J, Uvin P, Weyne E, Van Praet C, Merckx L, De Graeve N, Van Renterghem K, Cartuyvels R, Van den Abeele A. Use of fosfomycin as targeted antibiotic prophylaxis before prostate biopsy: A prospective randomized study. Int J Urol 2018; 26:391-397. [DOI: 10.1111/iju.13883] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 11/12/2018] [Indexed: 11/29/2022]
Affiliation(s)
| | - Pieter Uvin
- Department of Urology AZ Sint‐Lucas Hospital Ghent Belgium
| | - Emmanuel Weyne
- Department of Urology AZ Sint‐Lucas Hospital Ghent Belgium
| | | | - Luc Merckx
- Department of Urology AZ Sint‐Lucas Hospital Ghent Belgium
| | - Nico De Graeve
- Department of Urology AZ Sint‐Lucas Hospital Ghent Belgium
| | - Koenraad Van Renterghem
- Department of Urology Jessa Hospital Hasselt Belgium
- Department of Urology Sint Franciscus Hospital Heusden‐Zolder Belgium
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19
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Bouacida L, Suin V, Hutse V, Boudewijns M, Cartuyvels R, Debaisieux L, De Laere E, Hallin M, Hougardy N, Lagrou K, Oris E, Padalko E, Reynders M, Roussel G, Senterre JM, Stalpaert M, Ursi D, Vael C, Vaira D, Van Acker J, Verstrepen W, Van Gucht S, Kabamba B, Quoilin S, Muyldermans G. Distribution of HCV genotypes in Belgium from 2008 to 2015. PLoS One 2018; 13:e0207584. [PMID: 30517127 PMCID: PMC6281185 DOI: 10.1371/journal.pone.0207584] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: 03/30/2018] [Accepted: 11/03/2018] [Indexed: 01/25/2023] Open
Abstract
Background The knowledge of circulating HCV genotypes and subtypes in a country is crucial to guide antiviral therapy and to understand local epidemiology. Studies investigating circulating HCV genotypes and their trends have been conducted in Belgium. However they are outdated, lack nationwide representativeness or were not conducted in the general population. Methods In order to determine the distribution of different circulating HCV genotypes in Belgium, we conducted a multicentre study with all the 19 Belgian laboratories performing reimbursed HCV genotyping assays. Available genotype and subtype data were collected for the period from 2008 till 2015. Furthermore, a limited number of other variables were collected: some demographic characteristics from the patients and the laboratory technique used for the determination of the HCV genotype. Results For the study period, 11,033 unique records collected by the participating laboratories were used for further investigation. HCV genotype 1 was the most prevalent (53.6%) genotype in Belgium, with G1a and G1b representing 19.7% and 31.6%, respectively. Genotype 3 was the next most prevalent (22.0%). Further, genotype 4, 2, and 5 were responsible for respectively 16.1%, 6.2%, and 1.9% of HCV infections. Genotype 6 and 7 comprise the remaining <1%. Throughout the years, a stable distribution was observed for most genotypes. Only for genotype 5, a decrease as a function of the year of analysis was observed, with respectively 3.6% for 2008, 2.3% for 2009 and 1.6% for the remaining years. The overall M:F ratio was 1.59 and was mainly driven by the high M:F ratio of 3.03 for patients infected with genotype 3. Patients infected with genotype 3 are also younger (mean age 41.7 years) than patients infected with other genotypes (mean age above 50 years for all genotypes). The patients for whom a genotyping assay was performed in 2008 were younger than those from 2015. Geographical distribution demonstrates that an important number of genotyped HCV patients live outside the Belgian metropolitan cities. Conclusion This national monitoring study allowed a clear and objective view of the circulating HCV genotypes in Belgium and will help health authorities in the establishment of cost effectiveness determinations before implementation of new treatment strategies. This baseline characterization of the circulating genotypes is indispensable for a continuous surveillance, especially for the investigation of the possible impact of migration from endemic regions and prior to the increasing use of highly potent direct-acting antiviral (DAA) agents.
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Affiliation(s)
- Lobna Bouacida
- Sciensano, Laboratory of medical microbiology, Brussels, Belgium
| | - Vanessa Suin
- Sciensano, Viral diseases, Brussels, Belgium
- National reference center for hepatitis viruses, Belgium, Belgium
| | - Veronik Hutse
- Sciensano, Viral diseases, Brussels, Belgium
- National reference center for hepatitis viruses, Belgium, Belgium
| | | | | | | | | | | | - Nicolas Hougardy
- Clin. Sud Luxembourg, Site St-Joseph Labo D'analyses Médicales, Arlon, Belgium
| | - Katrien Lagrou
- UZ Leuven, Clinical Department of Laboratory Medicine, Leuven, and-KU Leuven, Department of Microbiology and Immunology, Leuven, Belgium
| | - Els Oris
- Ziekenhuis Oost-Limburg, Labo Klinische Biologie, Genk, Belgium
| | - Elizaveta Padalko
- UZ Ghent, Clinical Biology–Medical Microbiology Laboratory, Ghent, Belgium
| | - Marijke Reynders
- AZ Sint-Jan Brugge-Oostende AV, Laboratory Medicine, Brugge, Belgium
| | - Gatien Roussel
- Clinique St. Pierre, Laboratoire De Biologie Clinique, Ottignies, Belgium
| | | | | | - Dominique Ursi
- University Hospital Antwerp, Laboratory of Molecular Diagnostics in Microbiology, Antwerp, Belgium
| | - Carl Vael
- AZ KLINA, Clinical Laboratory, Brasschaat, Belgium
| | - Dolores Vaira
- CHU de Liège, Laboratoire de Référence SIDA-ULg, Liège, Belgium
| | | | | | - Steven Van Gucht
- Sciensano, Viral diseases, Brussels, Belgium
- National reference center for hepatitis viruses, Belgium, Belgium
| | - Benoit Kabamba
- National reference center for hepatitis viruses, Belgium, Belgium
- Cliniques Universitaires Saint-Luc, Labo Biologie Clinique Ria, Brussels, Belgium
| | - Sophie Quoilin
- Sciensano, Epidemiology of infectious diseases, Brussels, Belgium
| | - Gaëtan Muyldermans
- Sciensano, Epidemiology of infectious diseases, Brussels, Belgium
- * E-mail:
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20
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Baten E, Van der Aa F, Orye C, Cartuyvels R, van Renterghem K. PD64-05 A PROSPECTIVE ANALYSIS CONCERNING THE MICROBIAL RESISTANCE RATES IN PATIENTS UNDERGOING TURP. J Urol 2018. [DOI: 10.1016/j.juro.2018.02.2977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Baten E, Van der Aa F, Orye C, Cartuyvels R, van Renterghem K. MP15-08 A PROSPECTIVE ANALYSIS CONCERNING THE LIMITED CLINICAL CONSEQUENCES OF POSITIVE MICROBIAL CULTURES AFTER TURP. J Urol 2018. [DOI: 10.1016/j.juro.2018.02.521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Messiaen P, Forier A, Vanderschueren S, Theunissen C, Nijs J, Van Esbroeck M, Bottieau E, De Schrijver K, Gyssens IC, Cartuyvels R, Dorny P, van der Hilst J, Blockmans D. Outbreak of trichinellosis related to eating imported wild boar meat, Belgium, 2014. ACTA ACUST UNITED AC 2017; 21:30341. [PMID: 27684098 PMCID: PMC5032856 DOI: 10.2807/1560-7917.es.2016.21.37.30341] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Accepted: 01/04/2016] [Indexed: 11/20/2022]
Abstract
Trichinellosis is a rare parasitic zoonosis caused by Trichinella following ingestion of raw or undercooked meat containing Trichinella larvae. In the past five years, there has been a sharp decrease in human trichinellosis incidence rates in the European Union due to better practices in rearing domestic animals and control measures in slaughterhouses. In November 2014, a large outbreak of trichinellosis occurred in Belgium, related to the consumption of imported wild boar meat. After a swift local public health response, 16 cases were identified and diagnosed with trichinellosis. Of the 16 cases, six were female. The diagnosis was confirmed by serology or the presence of larvae in the patients' muscle biopsies by histology and/or PCR. The ensuing investigation traced the wild boar meat back to Spain. Several batches of imported wild boar meat were recalled but tested negative. The public health investigation allowed us to identify clustered undiagnosed cases. Early warning alerts and a coordinated response remain indispensable at a European level.
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Affiliation(s)
- Peter Messiaen
- Department of Infectious Diseases and Immunity, Jessa Hospital, Hasselt, Belgium
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Maes L, Carolus T, De Preter V, Ignoul S, Cartuyvels R, Braeken L, D'Huys PJ, Saegeman V, Kabamba B, Raymaekers M. Technical and clinical validation of three commercial real-time PCR kits for the diagnosis of neuroborreliosis in cerebrospinal fluid on three different real-time PCR platforms. Eur J Clin Microbiol Infect Dis 2016; 36:273-279. [PMID: 27714590 DOI: 10.1007/s10096-016-2797-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Accepted: 09/16/2016] [Indexed: 10/20/2022]
Abstract
This study reports the evaluation of the technical and clinical validation of the O-DiaBorburg kit (DIA), Borrelia burgdorferi PCR kit, ISEX (GENE), and Borrelia burgdorferi sensu lato Real-TM (SAC) for the diagnosis of neuroborreliosis in cerebrospinal fluid based on both Borrelia DNA and CSF samples from patients with clinical suspicion of neuroborreliosis. This validation study was done by analysing the kits on the Rotorgene Q (RGQ), CFX96, and LightCycler480 (LC480). For all kits, the linear range was larger on RGQ than on CFX96 and LC480. A good reproducibility was obtained for all assays on all instruments. Storage at -20 °C resulted in a decreased reproducibility for SAC. Results of the limit of detection (LOD95) experiments indicated a better sensitivity than described in the kit insert for all kits on all PCR platforms. No cross-reactivity was found for genetically related organisms nor for other pathogens which may be present in CSF. All species of the Borrelia burgdorferi sensu lato complex were detected with the GENE and SAC kits. The DIA kit failed to detect B. lusitaniae. The results seemed to indicate a better overall performance for the GENE kit on RGQ. However, its diagnostic value could not be confirmed in the clinical validation study, wherein none of the 103 CSF samples from clinical neuroborreliosis cases showed a positive real-time PCR result with the GENE kit analysed on RGQ.
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Affiliation(s)
- L Maes
- Research group Lab4U, Group of Management and Technology, UC Leuven-Limburg, Agoralaan gebouw B bus 3, 3590, Diepenbeek, Belgium.
| | - T Carolus
- Research group Lab4U, Group of Management and Technology, UC Leuven-Limburg, Agoralaan gebouw B bus 3, 3590, Diepenbeek, Belgium
| | - V De Preter
- Research group Lab4U, Group of Management and Technology, UC Leuven-Limburg, Agoralaan gebouw B bus 3, 3590, Diepenbeek, Belgium.,Translational Research Center for Gastrointestinal Disorders (TARGID), University Hospital Gasthuisberg, KULeuven, Leuven, Belgium
| | - S Ignoul
- Research group Lab4U, Group of Management and Technology, UC Leuven-Limburg, Agoralaan gebouw B bus 3, 3590, Diepenbeek, Belgium
| | - R Cartuyvels
- Clinical Biology, Laboratory for Molecular Diagnostics, Campus Salvator, Jessa Hospital, Salvatorstraat 20, 3500, Hasselt, Belgium
| | - L Braeken
- Research group Lab4U, Faculty of Industrial Engineering, KU Leuven - Campus Diepenbeek, Agoralaan gebouw B, 3590, Diepenbeek, Belgium
| | - P-J D'Huys
- Research group Lab4U, Group of Management and Technology, UC Leuven-Limburg, Agoralaan gebouw B bus 3, 3590, Diepenbeek, Belgium
| | - V Saegeman
- Department of Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium.,Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
| | - B Kabamba
- Clinical Microbiology, Laboratory of Microbiology, University Clinic St-Luc UCL, Avenue Mounier 10 F, 1200, Brussels, Belgium
| | - M Raymaekers
- Clinical Biology, Laboratory for Molecular Diagnostics, Campus Salvator, Jessa Hospital, Salvatorstraat 20, 3500, Hasselt, Belgium
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Peeters B, Magerman K, Waumans L, Cartuyvels R. Laboratory survey and literature review of anaerobic bacteriology: foundations of a clinically orientated and evidence-based workup for anaerobic cultures. Diagn Microbiol Infect Dis 2016; 86:15-22. [DOI: 10.1016/j.diagmicrobio.2016.06.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Revised: 06/02/2016] [Accepted: 06/05/2016] [Indexed: 12/22/2022]
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Desmet S, Verhaegen J, Glupzcynski Y, Van Eldere J, Melin P, Goossens H, Piérard D, Declercq P, Lagrou K, Boel A, Cartuyvels R, Denis O, Vandewal W, Saegeman V. Development of a national EUCAST challenge panel for antimicrobial susceptibility testing. Clin Microbiol Infect 2016; 22:704-10. [PMID: 27234934 DOI: 10.1016/j.cmi.2016.05.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [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: 12/09/2015] [Revised: 04/25/2016] [Accepted: 05/11/2016] [Indexed: 11/29/2022]
Abstract
A challenge panel of bacterial strains useful for clinical laboratories to validate their European Committee on Antimicrobial Susceptibility Testing (EUCAST) antimicrobial susceptibility test (AST) system was established. A total of 117 strains, obtained from Belgian Reference Centres (n = 57) and from routine clinical samples (n = 60) was selected based on resistance pattern. These strains were analysed in seven different laboratories by three different automated AST systems (Vitek (n = 2), Phoenix (n = 2) and Microscan (n = 2)) and by disc diffusion from five different manufacturers (Rosco (n = 2), Becton-Dickinson (n = 2), Biomérieux (n = 1), Bio-rad (n = 1) and i2a (n = 1)). To select the challenge panel, selection criteria were set for categorical agreement between the different systems and the number of very major errors, major errors and minor errors. Very major and major errors for at least two antibiotics were observed in 43% of all strains, leading to the exclusion of these strains from the selected panel. In only 10% of all tested strains was there 100% categorical agreement for all antibiotics. Finally, 28 strains (14 Gram-positive and 14 Gram-negative) covering a wide spectrum of resistance mechanisms were selected. Pilot-testing of this challenge panel in 20 laboratories mainly confirmed the results of the validation study. Only six strains withheld for the pilot study could not be used as challenge strain due to an overall (very) major error rate of >5% for a particular antibiotic (n = 5) or for two antibiotics (n = 1). To conclude, this challenge panel should facilitate the implementation and use of EUCAST breakpoints in laboratories.
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Affiliation(s)
- S Desmet
- Department of Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium; Department of Microbiology and Immunology, KU Leuven - University of Leuven, Leuven, Belgium.
| | - J Verhaegen
- Department of Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium; Department of Microbiology and Immunology, KU Leuven - University of Leuven, Leuven, Belgium
| | - Y Glupzcynski
- Belgian Reference Laboratory of Multi-resistant Enterobacteriaceae and Multi-resistant Pseudomonas and Acinetobacter, CHU Dinant-Godinne UCL-Namur, Belgium
| | - J Van Eldere
- Department of Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium; Department of Microbiology and Immunology, KU Leuven - University of Leuven, Leuven, Belgium
| | - P Melin
- Belgian Reference Centre for Streptococcus agalactiae, Department of Clinical Microbiology, University Hospital of Liege, Liege, Belgium
| | - H Goossens
- Belgian Reference Laboratory of Enterococcus spp, Streptococcus pyogenes and other beta-hemolytic streptococci non-group B, University Hospital Antwerp, Antwerp, Belgium
| | - D Piérard
- Department of Laboratory Medicine, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - P Declercq
- Department of Laboratory Medicine, Sint-Jozefskliniek, Izegem, Belgium
| | - K Lagrou
- Department of Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium; Department of Microbiology and Immunology, KU Leuven - University of Leuven, Leuven, Belgium
| | - A Boel
- Clinical Laboratory of Microbiology OLVZ Aalst, Aalst, Belgium
| | - R Cartuyvels
- Department of Laboratory Medicine, Jessa Hasselt, Hasselt, Belgium
| | - O Denis
- Belgian Reference Laboratory of Staphylococcus aureus, Hopital Erasme, Brussels, Belgium
| | - W Vandewal
- Department of Laboratory Medicine, AZ Sint-Lucas Brugge, Brugge, Belgium
| | - V Saegeman
- Department of Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium; Department of Microbiology and Immunology, KU Leuven - University of Leuven, Leuven, Belgium
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Verhoye E, Vandecandelaere P, De Beenhouwer H, Coppens G, Cartuyvels R, Van den Abeele A, Frans J, Laffut W. A hospital-level cost-effectiveness analysis model for toxigenic Clostridium difficile detection algorithms. J Hosp Infect 2015; 91:123-8. [PMID: 26231269 DOI: 10.1016/j.jhin.2015.06.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [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: 08/06/2014] [Accepted: 02/13/2015] [Indexed: 12/24/2022]
Abstract
BACKGROUND Despite thorough analyses of the analytical performance of Clostridium difficile tests and test algorithms, the financial impact at hospital level has not been well described. Such a model should take institution-specific variables into account, such as incidence, request behaviour and infection control policies. AIM To calculate the total hospital costs of different test algorithms, accounting for days on which infected patients with toxigenic strains were not isolated and therefore posed an infectious risk for new/secondary nosocomial infections. METHODS A mathematical algorithm was developed to gather the above parameters using data from seven Flemish hospital laboratories (Bilulu Microbiology Study Group) (number of tests, local prevalence and hospital hygiene measures). Measures of sensitivity and specificity for the evaluated tests were taken from the literature. List prices and costs of assays were provided by the manufacturer or the institutions. The calculated cost included reagent costs, personnel costs and the financial burden following due and undue isolations and antibiotic therapies. Five different test algorithms were compared. FINDINGS AND CONCLUSION A dynamic calculation model was constructed to evaluate the cost:benefit ratio of each algorithm for a set of institution- and time-dependent inputted variables (prevalence, cost fluctuations and test performances), making it possible to choose the most advantageous algorithm for its setting. A two-step test algorithm with concomitant glutamate dehydrogenase and toxin testing, followed by a rapid molecular assay was found to be the most cost-effective algorithm. This enabled resolution of almost all cases on the day of arrival, minimizing the number of unnecessary or missing isolations.
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Affiliation(s)
- E Verhoye
- Laboratory of Microbiology, Onze-Lieve-Vrouw Hospital, Aalst, Belgium.
| | | | - H De Beenhouwer
- Laboratory of Microbiology, Onze-Lieve-Vrouw Hospital, Aalst, Belgium
| | - G Coppens
- Clinical Laboratory, Hospital Oost-Limburg, Genk, Belgium
| | - R Cartuyvels
- Clinical Laboratory, Jessa Hospital, Hasselt, Belgium
| | - A Van den Abeele
- Laboratory of Microbiology, General Hospital Sint-Lucas, Gent, Belgium
| | - J Frans
- Clinical Laboratory, Imelda Hospital, Bonheiden, Belgium
| | - W Laffut
- Clinical Laboratory, Heilig Hart Hospital, Lier, Belgium
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Maurissen W, Sutter GD, Beenhouwer HD, Frans J, Abeele AMVD, Cartuyvels R, Laffut W, Vandecandelaere P, Coppens G. Establishing quality control ranges for temocillin following CLSI-M23-A3 guideline. Acta Clin Belg 2015; 70:11-5. [PMID: 25176405 DOI: 10.1179/2295333714y.0000000066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVES This study aimed to establish acceptable quality control ranges for temocillin disk diffusion tests and Etest(®) minimal inhibitory concentrations. METHODS According to Clinical and Laboratory Standards Institute (CLSI) guideline, a Tier 2 quality control study was performed and involves seven laboratories. Each of them tested 10 replicates of two quality control strains (Escherichia coli ATCC 25922 and E. coli ATCC 35218) on three different media lots and, for disk diffusion, two disk lots. RESULTS Proposed zone diameter quality control ranges were 12-25 mm for E. coli ATCC 25922 and 19-28 mm for E. coli ATCC 35218. Proposed Etest quality control ranges were 3-24 mg/l for E. coli ATCC 25922 and 2-6 mg/l E. coli ATCC 35218. CONCLUSION Based on our results, we would advise the use of E. coli ATCC 35218 as QC strain for temocillin susceptibility testing and Etest because ranges obtained are narrower than with E. coli ATCC 25922 and do not overlap temocillin breakpoint.
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Affiliation(s)
| | | | | | - J. Frans
- Imelda ziekenhuisBonheiden, Belgium
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Vanhoof R, Carpentier M, Cartuyvels R, Damée S, Fagnart O, Garrino MG, Glupczynski Y, Gordts B, Govaerts D, Magerman K, Mans I, Surmont I, Van Bossuyt E, Van De Vyvere M, Van Landuyt H, Van Nimmen L, Van Noyen R. SURVEILLANCE OF ANTIBIOTIC RESISTANCE IN CLINICAL ISOLATES OFSTREPTOCOCCUS PNEUMONIAECOLLECTED IN BELGIUM DURING WINTER 2000-2001. Acta Clin Belg 2014. [DOI: 10.1179/acb.2003.58.2.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Willems E, Cartuyvels R, Magerman K, Verhaegen J. Evaluation of 3 different agar media for rapid detection of extended-spectrum β-lactamase-producing Enterobacteriaceae from surveillance samples. Diagn Microbiol Infect Dis 2014; 76:16-9. [PMID: 23608349 DOI: 10.1016/j.diagmicrobio.2013.02.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2012] [Revised: 02/07/2013] [Accepted: 02/19/2013] [Indexed: 11/27/2022]
Abstract
Rapid detection of extended-spectrum β-lactamase (ESBL)-producing Gram-negative bacilli in surveillance samples of high-risk patients allows early optimization of antimicrobial therapy and timely introduction of infection control procedures. This study evaluated the BLSE (AES Chemunex), chromID ESBL (bioMérieux), and Brilliance ESBL agar (Oxoid) for rapid detection of ESBL-producing Enterobacteriaceae from surveillance samples. A total of 139 perineal and nose samples were processed. Isolated bacterial strains were identified by mass spectrometry. ESBL confirmation was performed by phenotypical and molecular tests. Overall, 16 ESBL-producing Enterobacteriaceae were recovered. The sensitivities after 24 h of incubation were comparable (BLSE, 87.5%; Brilliance ESBL, 87.5%; and chromID, 81.3%). The specificity of chromogenic media (80.7-82.1%) was significantly higher compared to BLSE (60.8%). All 3 media are reliable to screen for ESBL-producing Enterobacteriaceae from surveillance samples. Yet, the main advantages of chromogenic media over BLSE reside in their chromogenic character and higher specificity, reducing the total number of isolates that require further identification and ESBL confirmation testing.
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Affiliation(s)
- Elise Willems
- Department of Clinical Microbiology, University Hospital Leuven, Herestraat 49, 3000 Leuven, Belgium.
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Naesens R, Magerman K, Gyssens I, Leenders A, Meekelenkamp J, Van Esbroeck M, CoppensG, Oris E, Craeghs J, Thoelen I, Gabriëls P, Vandevelde M, Forier AM, Waumans L, Cartuyvels R. Q fever across the Dutch border in Limburg province, Belgium. Eur J Clin Microbiol Infect Dis 2012; 31:2053-5. [PMID: 22290347 DOI: 10.1007/s10096-011-1539-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2011] [Accepted: 12/21/2011] [Indexed: 10/14/2022]
Abstract
Data from three different data sources were compiled to estimate the presence of Coxiella burnetii in the Belgian Limburg province for both humans and livestock. First, serological data of all samples sent to the Belgian reference centre (2003–2010) for human Q fever were analysed, showing evidence for an acute Q fever infection in 1–5% of the cases. Second, a multi-centre prospective survey was conducted in Limburg in 2010 to detect undiagnosed human cases; evidence for a recent infection with Coxiella burnetii was found in three out of 100 patients from which clinicians suspected a Mycoplasma pneumoniae infection. Third, we analyzed data from the Belgian livestock screening program (2009–2010) which consisted of investigating all reported abortions, sampling tank milk, and serological screening of cattle. The results suggest an endemicity in the Limburgian livestock which seems to be especially high in cattle.
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Willems E, Cartuyvels R, Magerman K, Raymaekers M, Verhaegen J. Comparison of different phenotypic assays for the detection of extended-spectrum β-lactamase production by inducible AmpC-producing Gram-negative bacilli. Eur J Clin Microbiol Infect Dis 2012; 32:549-55. [DOI: 10.1007/s10096-012-1772-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2012] [Accepted: 10/23/2012] [Indexed: 10/27/2022]
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Pauwels S, De Moor B, Stas K, Magerman K, Gyssens IC, Van Ranst M, Cartuyvels R. Coxsackievirus B1 peritonitis in a patient treated with continuous ambulatory peritoneal dialysis: a case report and brief review of the literature. Clin Microbiol Infect 2012; 18:E431-4. [PMID: 22882320 DOI: 10.1111/j.1469-0691.2012.03985.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
We report a case of viral peritonitis caused by coxsackievirus B1 in a 79-year-old male undergoing continuous ambulatory peritoneal dialysis (CAPD), and review the English language literature. Clinicians should be aware of viral peritonitis in patients on CAPD presenting with a viral syndrome and mononuclear peritoneal dialysis effluent. Currently, viral diagnostic tests are available to confirm the diagnosis and avoid unnecessary treatment with antibiotics.
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Affiliation(s)
- S Pauwels
- Laboratory Medicine, University Hospitals Leuven, Catholic University of Leuven, Leuven, Belgium.
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Chai L, Naesens R, Khoo A, Abeele M, van Renterghem K, Cartuyvels R, Netea M, Gyssens I. Invasive fungal infection in an elderly patient with defective inflammatory macrophage function. Clin Microbiol Infect 2011; 17:1546-9. [DOI: 10.1111/j.1469-0691.2011.03598.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Raymaekers M, de Rijke B, Pauli I, Van den Abeele AM, Cartuyvels R. Timely diagnosis of respiratory tract infections: evaluation of the performance of the Respifinder assay compared to the xTAG respiratory viral panel assay. J Clin Virol 2011; 52:314-6. [PMID: 21925937 PMCID: PMC7185546 DOI: 10.1016/j.jcv.2011.08.017] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2011] [Revised: 08/10/2011] [Accepted: 08/16/2011] [Indexed: 11/30/2022]
Abstract
Background Respiratory tract infections are the most common cause of hospitalization in infants and young children and are typically caused by viral or, less commonly, bacterial pathogens. Existing non-molecular diagnostic methods have several drawbacks such as limited sensitivity, long turn-a-round time and limited number of pathogens that can be detected. Objectives Nucleic acid amplification methods can increase sensitivity and enable the initiation of appropriate interventions without delay. Broad-spectrum detection and identification circumvent the use of individual diagnostic DNA or RNA based assays. At present, several commercial assays are available for broad-spectrum detection. Study design We compared the performance of the xTAG Respiratory Viral Panel (RVP) (Luminex Molecular Diagnostics, Toronto, Canada) with that of the Respifinder (Pathofinder, Maastricht, Netherlands) for 9 external quality assurance (EQA) panels (QCMD, Scotland) consisting of a total of 106 EQA samples. Results Both the RVP and the Respifinder assay have an excellent specificity. Sensitivity was 33% and 78% for the RVP and the Respifinder assay, respectively. For both assays, sensitivity was low for weak positive samples. Discussion The results of our study seem to indicate a better sensitivity for the Respifinder. Analysis of patient samples is necessary to evaluate the clinical performance.
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Affiliation(s)
- M Raymaekers
- Clinical Laboratory, Jessa Hospital, Site Virga Jesse, Stadsomvaart 11, B-3500 Hasselt, Belgium.
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Naesens R, Magerman K, Cartuyvels R, Vanden Abeele M, van Renterghem K, Gyssens IC. Testicular mass in a geriatric patient. Neth J Med 2011; 69:137-139. [PMID: 21444942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Affiliation(s)
- R Naesens
- Department of Medical Microbiology, Jessa Hospital, Hasselt, Belgium.
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Vijgen S, Nys S, Naesens R, Magerman K, Boel A, Cartuyvels R. Comparison of Vitek identification and antifungal susceptibility testing methods to DNA sequencing and Sensititre YeastOne antifungal testing. Med Mycol 2011; 49:107-10. [DOI: 10.3109/13693786.2010.494255] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [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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Vanhoof R, Camps K, Carpentier M, De Craeye S, Frans J, Glupczynski Y, Goffinet P, Gordts B, Govaerts D, Ide L, Lefèvre P, Lontie M, Cartuyvels R, Meunier F, Mulongo B, Philippart I, Surmont I, Van Bossuyt E, Van Eldere J, Verhaegen J. 10th Survey of antimicrobial resistance in noninvasive clinical isolates of Streptococcus pneumoniae collected in Belgium during winter 2007–2008. ACTA ACUST UNITED AC 2010; 58:147-51. [DOI: 10.1016/j.patbio.2009.07.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2009] [Accepted: 07/13/2009] [Indexed: 10/20/2022]
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Nys S, Vijgen S, Magerman K, Cartuyvels R. Comparison of Copan eSwab with the Copan Venturi Transystem for the quantitative survival of Escherichia coli, Streptococcus agalactiae and Candida albicans. Eur J Clin Microbiol Infect Dis 2010; 29:453-6. [PMID: 20204445 DOI: 10.1007/s10096-010-0883-5] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2009] [Accepted: 01/31/2010] [Indexed: 11/25/2022]
Abstract
Swab transport systems should preserve the viability and stability of micro-organisms in clinical specimens throughout transport and storage. eSwab, a nylon-tipped swab in liquid medium, designed for better specimen collection and less micro-organism entrapment, was evaluated for the maintenance of viability and quantitative survival of Escherichia coli, Streptococcus agalactiae and Candida albicans. The quantitative elution method was used to evaluate eSwab in vitro. In vitro, the recovery of the three micro-organisms was higher in eSwab (97-100%) as compared to the Copan Venturi Transystem (CVT) (86-96%) at room temperature (RT) for time point 0 h and remained similar after 6 h. E. coli and C. albicans proliferated in both transport systems when preserved beyond 6 h. At 4 degrees C, the recovery of eSwab was higher (>94%) compared to CVT (77-94%) for the micro-organisms tested. eSwab did not only meet the Clinical Laboratory and Standards Institute (CLSI) criteria for microbiological transport devices, but as its recovery rate in vitro was higher than that of CVT, it might also enhance the sensitivity of bacterial culture in the future.
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Affiliation(s)
- S Nys
- Clinical Laboratory, Virga Jesse Hospital, Hasselt, Belgium.
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Raymaekers M, de Rijke B, Pauli I, Van den Abeele AM, Cartuyvels R. OP4-2 Timely diagnosis of respiratory tract infections: evaluation of the performance of the respifinder assay compared to the RVP assay. J Clin Virol 2009. [PMCID: PMC7129852 DOI: 10.1016/s1386-6532(09)70057-5] [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: 11/26/2022]
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40
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Abstract
Real-time polymerase chain reaction (PCR) is a frequently used technique in molecular diagnostics. To date, practical guidelines for the complete process of optimization and validation of commercial and in-house developed molecular diagnostic methods are scare. Therefore, we propose a practical guiding principle for the optimization and validation of real-time PCR assays. Based on literature, existing guidelines, and personal experience, we created a checklist that can be used in different steps of the development and validation process of commercial and in-house developed real-time PCR assays. Furthermore, determination of target values and reproducibility of internal quality controls are included, which allows a statistical follow-up of the performance of the assay. Recently, we used this checklist for the development of various qualitative and quantitative assays for microbiological and hematological applications, for which accreditation according to ISO 15189:2007 was obtained. In our experience, the use of the proposed guidelines leads to a more efficient and standardized optimization and validation. Ultimately, this results in reliable and robust molecular diagnostics. The proposed checklist is independent of environment, equipment, and specific applications and can be used in other laboratories. A worldwide consensus on this kind of checklist should be aimed at.
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Affiliation(s)
- Marijke Raymaekers
- Molecular Biology, Clinical Laboratory, Virga Jesse Hospital, Hasselt, Belgium.
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41
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Van Petegem M, Cartuyvels R, de Schouwer P, van Duppen V, Goossens W, van Hove L. Comparative evaluation of three flow cytometers for reticulocyte enumeration. Clin Lab Haematol 2008; 15:103-11. [PMID: 8348772 DOI: 10.1111/j.1365-2257.1993.tb00133.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Flow cytometric determination of reticulocytosis is progressively replacing the manual microscopic method. We evaluated three flow cytometers (Becton Dickinson FACScan, Coulter EPICS Profile II, Ortho Cytoron Absolute) for reticulocyte enumeration, using thiazole orange. For each sample, 30,000 cells were analysed. In order to comparatively evaluate the three instruments, reticulocytes were counted by manually gating the erythroid population and evaluating the gated population for fluorescence characteristics. The different instruments showed good linearity and precision. No carry-over was observed. Orthogonal regression analysis of reticulocyte counts of 100 healthy blood donor samples and 108 haematological patient samples showed a good mutual comparability between all three instruments tested, although the paired t-test showed a significant difference between the Cytoron and both the FACScan and the Profile. Despite minor statistical differences, the three instruments can be considered equivalent for daily routine reticulocyte enumeration.
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Affiliation(s)
- M Van Petegem
- University Hospital Leuven, Department of Haematology, Belgium
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42
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Gabriels P, Joosen H, Put E, Verhaegen J, Magerman K, Cartuyvels R. Recurrent Rhodococcus equi infection with fatal outcome in an immunocompetent patient. Eur J Clin Microbiol Infect Dis 2007; 25:46-8. [PMID: 16424975 DOI: 10.1007/s10096-005-0068-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The majority of human Rhodococcus equi infections occur in immunocompromised hosts, especially those with AIDS, and infection in immunocompetent patients is rare. Reported here is a case of R. equi infection in a seemingly healthy patient with a very complicated course. Despite neurosurgery and prolonged antibiotic therapy the patient deceased.
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Affiliation(s)
- P Gabriels
- Clinical Laboratory, Sint-Trudo Hospital, Diestersteenweg 100, 3800, Sint-Truiden, Belgium
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43
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Glupczynski Y, Behrin C, Allemeersch D, André M, De Beenhouwer H, Cartuyvels R, Frans J, Govaerts D, Joseph R, Phillipart I, Surmont I, Van den Abeele AM, Verhaegen J, Nonhoff C, Denis O, Struelens M. P1827 Prevalence of methicillin-resistant Staphylococcus aureus with reduced susceptibility to glycopeptides in Belgian hospitals: results of a multicentre survey. Int J Antimicrob Agents 2007. [DOI: 10.1016/s0924-8579(07)71666-7] [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: 11/27/2022]
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44
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Vanwynsberghe T, Boel A, Cartuyvels R, Raymaekers M, De Beenhouwer H. P671 Emergence of Klebsiella pneumoniae with an AmpC and blaSHV–11 in a Belgian hospital. Int J Antimicrob Agents 2007. [DOI: 10.1016/s0924-8579(07)70512-5] [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: 11/25/2022]
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45
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Vanwynsberghe T, Verhamme K, Raymaekers M, Cartuyvels R, Boel A, De Beenhouwer H. Outbreak of Klebsiella pneumoniae strain harbouring an AmpC (DHA-1) and a blaSHV-11 in a Belgian hospital, August-December 2006. ACTA ACUST UNITED AC 2007; 12:E070201.3. [PMID: 17370947 DOI: 10.2807/esw.12.05.03130-en] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A hospital in the northwest of Belgium has recorded 22 clinical isolates of Klebsiella pneumoniae expressing an unusual pattern of antibiotic susceptibility when testing for extended-spectrum beta-lactamases (ESBL) between August and December 2006.
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Affiliation(s)
- T Vanwynsberghe
- Department of clinical microbiology, OLV Hospital, Aalst, Belgium
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46
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Vanhoof R, Carpentier M, Cartuyvels R, Damée S, Fagnart O, Frans J, Gordts B, Glupczynski Y, Goffinet P, Govaerts D, Lefèvre PH, Lontie M, Magerman K, Mans I, Meunierz F, Moonens F, Surmont I, Van Bossuyt E, Van De Vyvere M, Van Eldere J, Van Landuyt H, Van Nimmen L, Van Noyen R, Verhaegen J. Surveillance of antibiotic resistance in non invasive clinical isolates of Streptococcus pneumoniae collected in Belgium during winters 2003 and 2004. Acta Clin Belg 2006; 61:49-57. [PMID: 16792334 DOI: 10.1179/acb.2006.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
A total of 391 and 424 non-invasive isolates of Streptococcus pneumoniae collected by 15 laboratories during the 2003 and 2004 survey were tested for their susceptibility by a microdilution technique following NCCLS recommendations. Insusceptibility rates (IR) in the two surveys (2003/2004) were as follows: penicillin 15.0/14.7% [8.4/6.4% Resistance (R)], ampicillin 17.4/14.6% (R 9.0/7.1%), amoxicillin +/- clavulanic acid 2.6/1.2 % (R 0/0%), cefaclor 14.3/14.1% (R 11.5/13.4%), cefuroxime 13.6/12.7% (R 10.5/11.8%), cefuroxime-axetil 10.5/11.8% (R 10.0/9.2%) (breakpoints based on 250 mg), cefotaxime 4.9/6.2% (R 1.3/2.4%), ceftazidime NotTested (NT)/6.4 (R NT/2.6%), cefepime NT/6.4 (R NT/2.6%), imipenem 7.7/8.9 % (R 1.8/1.4%), ertapenem 0.8/NT% (R O/NT%), ciprofloxacin 13.8/9.0% (R 4.3/2.4%), levofloxacin 3.3/2.8% (R 1.5/0.2%), moxifloxacin 0.6/0.2% (R 0.3/0%), ofloxacin 13.5/9.0% (R 4.3/2.4%), erythromycin 26.1/24.7% (R 25.3/24.5%), azithromycin 25.4/24.7% (R 24.6/24.5%), telithromycin 0.8/0.2% (R 0.5/0%), clindamycin 21.2/18.4% (R 19.2/17.7%) and tetracycline 32.3/22.1% (R 29.2/19.3%). There were only minor differences in resistance rates according to age, sample site, admission type (i.e. ambulatory, hospitalized or long-term care facility patients), gender and geographic origin. Overall, telithromycin (MIC50, MIC90 in 2003/2004: 0.015 microg/ml, 0.12 microg/ml/ 0.008,0.06 respectively), ertapenem (0.03; 0.25/NT), moxifloxacin (0.06; 0.25/0.06, 0.12), and amoxicillin +/- clavulanic acid (0.03; 0.25/0.015, 0.5) were the most active compounds in both surveys. In 2003, the most common resistance phenotype was isolated insusceptibility to tetracycline (10.5%) followed by combined insusceptibility to erythromycin and tetracycline (9.3%). Erythromycin-tetracycline resistance (10.4%) was the most common in 2004. Isolates showing resistance to an antibiotic were significantly more present in 2003 than in 2004 (50.4% versus 40.8%). In penicillin-insusceptible isolates, MICs of all beta-lactams were increased but cross-resistance between penicillin and other beta-lactams in the penicillin-insusceptible isolates was not complete. In the 2003 survey, most of these isolates remained fully susceptible to ertapenem (94.9%) and amoxicillin +/- clavulanic acid (83.1%). In the 2004 survey, 91.9% of the penicillin insusceptible isolates remained susceptible to amoxicillin +/- clavulanic acid. In both surveys, the most common serotypes in penicillin insusceptible isolates were 14, 23,19 and 9 (20.0%, 20.0%, 16.4% and 10.9% respectively in 2003; 41.6%, 11.7%, 15.0% and 18.3% respectively in 2004).
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Affiliation(s)
- R Vanhoof
- Pasteurinstituut, Brussel, Eenheid Antibiotica-Onderzoek, Engelandstraat 642, B-1180 Brussel.
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47
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Bailleul E, Magerman K, Mewis A, Peeters V, Rummens JL, Cartuyvels R. False-positive result with BinaxNOW Legionella Antigen immunochromatographic (ICT) assay: response to Helbig et al. (2001). J Med Microbiol 2004; 53:173. [PMID: 14729941 DOI: 10.1099/jmm.0.05000-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- E Bailleul
- Clinical Biology, Virga Jesse Ziekenjuis, Stadsomvaart 11, 3500 Hasselt, Belgium
| | - K Magerman
- Clinical Biology, Virga Jesse Ziekenjuis, Stadsomvaart 11, 3500 Hasselt, Belgium
| | - A Mewis
- Clinical Biology, Virga Jesse Ziekenjuis, Stadsomvaart 11, 3500 Hasselt, Belgium
| | - V Peeters
- Clinical Biology, Virga Jesse Ziekenjuis, Stadsomvaart 11, 3500 Hasselt, Belgium
| | - J-L Rummens
- Clinical Biology, Virga Jesse Ziekenjuis, Stadsomvaart 11, 3500 Hasselt, Belgium
| | - R Cartuyvels
- Clinical Biology, Virga Jesse Ziekenjuis, Stadsomvaart 11, 3500 Hasselt, Belgium
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48
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Nijs A, Cartuyvels R, Mewis A, Peeters V, Rummens JL, Magerman K. Comparison and evaluation of Osiris and Sirscan 2000 antimicrobial susceptibility systems in the clinical microbiology laboratory. J Clin Microbiol 2003; 41:3627-30. [PMID: 12904366 PMCID: PMC179852 DOI: 10.1128/jcm.41.8.3627-3630.2003] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The Osiris and Sirscan 2000 systems are two semiautomated systems that can be used to read and interpret the results on disk diffusion agar plates. They are both used for determination of susceptibility to antimicrobial agents. The present study compared both systems versus the NCCLS standard method of visual reading with a ruler. Both inpatient and outpatient samples with a total of 315 nonfastidious gram-negative strains were obtained. In total, 3724 organism-antimicrobial agent combinations that fulfilled the NCCLS guidelines for disk diffusion susceptibility testing were evaluated prospectively. The results obtained with both systems in comparison with those obtained by the classical nonautomated means of interpretation were excellent, with correlation coefficients of 0.96 for both systems. The overall agreements for susceptibility interpretation were 96.56 and 96.24% with the Osiris and Sirscan systems, respectively. Very major errors were obtained for 8 (1.07%) and 10 (1.34%) organism-antimicrobial agent combinations with the Osiris and Sirscan systems, respectively. In addition, major errors were obtained for 2 (0.07%) and 6 (0.21%) combinations with the Osiris and Sirscan systems, respectively. Minor errors were obtained for 118 and 124 organism-antimicrobial agent combinations with the Osiris and Sirscan systems, respectively. Overall, both the Osiris system and the Sirscan system are comparable and reliable systems for determination of interpretative categories from the zone diameters of standard disk diffusion test plates.
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Affiliation(s)
- A Nijs
- Department of Clinical Laboratory, Virga Jesseziekenhuis, Stadsomvaart 11, B-3500 Hasselt, Belgium
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49
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Boudewijns M, Raes M, Peeters V, Mewis A, Cartuyvels R, Magerman K, Rummens JL. Evaluation of platelet function on cord blood in 80 healthy term neonates using the Platelet Function Analyser (PFA-100); shorter in vitro bleeding times in neonates than adults. Eur J Pediatr 2003; 162:212-3. [PMID: 12659096 DOI: 10.1007/s00431-002-1093-7] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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50
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Vanhoof R, Carpentier M, Cartuyvels R, Damée S, Fagnart O, Garrino MG, Glupczynski Y, Gordts B, Govaerts D, Magerman K, Mans I, Surmont I, Van Bossuyt E, Van De Vyvere M, Van Landuyt H, Van Nimmen L, Van Noyen R. Surveillance of antibiotic resistance in clinical isolates of Streptococcus pneumoniae collected in Belgium during winter 2000-2001. Acta Clin Belg 2003; 58:111-9. [PMID: 12836494] [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: 03/03/2023]
Abstract
A total of 314 isolates of Streptococcus pneumoniae collected by 10 different laboratories were tested for their susceptibility by using a microdilution technique following NCCLS recommendations. The following antibiotics were included: penicillin, ampicillin, amoxicillin, amoxicillin/clavulanate, cefaclor, cefuroxime, cefotaxime, imipenem, ciprofloxacin, gemifloxacin, levofloxacin, erythromycin, clarithromycin, azithromycin, miocamycin, clindamycin and tetracycline. The insusceptibility rate (IR) to penicillin was 21.0% [10.8% intermediate (> or = 0.12-1 microgram/mL) and 10.2% high-level (> or = 2 micrograms/mL)], to cefotaxime 7.3% [3.5% intermediate (> or = 1 microgram/mL) and 3.8% high-level (> or = 2 micrograms/mL)], to imipenem 3.8% [3.8% intermediate (> or = 0.25-0.5 microgram/mL) and 0% high-level (> or = 1 microgram/mL)], to ciprofloxacin 11.2% [8.3% intermediate (2 micrograms/mL) and 3.9% high-level (> or = 4 micrograms/mL)], to erythromycin 30.3% [3.5% intermediate (0.5 microgram/mL) and 26.8% high-level (> or = 1 microgram/mL)] and to tetracycline 38.5% [0.9% intermediate (4 micrograms/mL) and 37.6% high-level (> or = 8 micrograms/mL)]. No decreased susceptibility was found for gemifloxacin (> or = 0.5 microgram/mL). This compound was the most active with MIC50, MIC90 and an IR of 0.015 microgram/mL, 0.03 microgram/mL and 0% respectively, followed by amoxicillin/clavulanate, amoxicillin and imipenem (MIC50, MIC90 and IR: 0.015 microgram/mL, 1 microgram/mL, 1.6%/0.015 microgram/mL, 1 microgram/mL, 1.9%/0.008 microgram/mL, 0.12 microgram/mL, 3.8% respectively). Compared to the 1999 surveillance, penicillin and tetracycline-insusceptibility increased with 4.9% and 15.6% respectively, while cefotaxime, erythromycin and ciprofloxacin insusceptibility decreased with 5.4%, 5.8% and 4.4% respectively. MICs of all beta-lactams rose with those of penicillin for penicillin-insusceptible isolates. Imipenem, cefotaxime, amoxicillin and amoxicillin/clavulanate were generally 4, 2, 1 and 1 doubling dilutions respectively more potent than penicillin on these isolates while ampicillin, cefuroxime and cefactor were generally 1, 2 and 4 dilutions respectively [table: see text] less potent. Most penicillin-insusceptible isolates remained fully susceptible to amoxicillin/clavulanate (92.4%), amoxicillin (90.9%) and imipenem (81.8%). Erythromycin-tetracycline insusceptibility was the most common resistance phenotype (14.3%). Three- and four-fold resistance was found in 12.4% and 1.6% respectively of the isolates. Most penicillin-insusceptible isolates were of capsular types 14 (22.7%), 23 (21.2%), 6 (18.2%), 9 (13.6%) and 19 (12.1%).
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Affiliation(s)
- R Vanhoof
- Pasteurinstituut-Brussel, Eenheid Antibiotica-Onderzoek, Engelandstraat 642, B-1180 Brussel
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