Eurosurveillance最新文献

Analysis of 594 isolates of Escherichia coli sequence type (ST)131 and its single locus variants carrying carbapenemase genes from 17 European Union/European Economic Area countries revealed acquisition of 18 carbapenemase variants, mainly in ST131 clades A and C. Most frequent were bla _OXA-244 (n = 230) and bla _OXA-48 (n = 224), detected in 14 and 12 countries, respectively. Isolates carrying bla _OXA-244 have increased rapidly since 2021. The increasing detection of carbapenemase genes in the E. coli high-risk lineage ST131 is a public health concern.

BackgroundAntibiotic resistance poses a considerable public health threat, with data-driven stewardship a main prevention measure. While quantifying antibiotic consumption is a key component of antibiotic stewardship programmes, the choice of denominator for calculating this metric can impact comparative analyses and trend evaluations substantially, influencing targeted stewardship interventions.AimWe aim to evaluate how using hospital sector-specific antibiotic consumption rate denominators at country level impacts country rankings and trends, addressing the limitations of the commonly used 'defined daily doses (DDD) per 1,000 inhabitants per day' metric.MethodsHospital antibiotic consumption data from ESAC-Net and denominator data from Eurostat ('inhabitants,' 'bed-days' and 'discharges') for 2017-2021 were used to calculate hospital antibiotic consumption rates for 24 reporting European Union/ European Economic Area (EU/EEA) countries. Countries were ranked by their consumption rates and trends were analysed to assess the effects of using different denominators.ResultsCountry rankings and 5-year trend analyses varied depending on the denominator used. Antibiotic consumption rates were more similar when using hospital activity-based denominators 'bed-days' and 'discharges' compared with the population-based 'inhabitants' denominator. Differences in country rankings and trends were also seen among rates derived using 'bed-days' and 'discharges'.ConclusionThe study underscores the importance of using hospital activity-based denominators such as 'bed-days' and 'discharges' when evaluating hospital antibiotic consumption. ESAC-Net's historical reliance on only 'DDD per 1,000 inhabitants per day' is challenged, advocating for the use of multiple hospital activity-based denominators. Corresponding hospital activity denominators for ESAC-Net data will more effectively inform national hospital antibiotic stewardship interventions.

The COVID-19 pandemic and related preventive measures reduced influenza virus circulation, notably causing the disappearance of the B/Yamagata lineage of influenza viruses. In this Perspective, we discuss the implications that this development may have for global influenza epidemiology, and the adjustments that may need to be implemented concerning surveillance strategies and practices, laboratory safety protocols, and influenza vaccine formulations. The disappearance of the B/Yamagata lineage might indeed alter the dynamics of the influenza disease burden (although in a way that is difficult to predict at the moment), and associated diagnostic practices, and may also necessitate updated biosafety levels and revised influenza surveillance strategies. Furthermore, the World Health Organization (WHO) recommended in September 2023 the exclusion of B/Yamagata antigens from future vaccines, with a shift towards trivalent vaccines or modified quadrivalent vaccines; this new scenario underscores the importance of robust global respiratory virus surveillance, effective communication with healthcare professionals and the population to maintain trust in vaccines, and a collaborative approach among health policymakers and vaccine manufacturers to navigate this epidemiological change.

Between August and 28 October 2024, 199 autochthonous cases of dengue virus serotype 2 were notified in the city of Fano, central Italy. We describe the ongoing epidemiological and microbiological investigation and public health measures implemented to contain the outbreak. The high transmissibility and the extension of the outbreak suggest that dengue should be expected in temperate regions during favourable seasons, highlighting the need for heightened awareness among healthcare providers and the public to ensure timely detection and response.

A food-borne outbreak with about 200 Salmonella Umbilo cases occurred mainly between July and September 2024 in several European countries. Collaborative work between outbreak teams in Germany, Austria and Denmark, including epidemiological and microbiological investigations, allowed to rapidly identify rocket salad as the likely infection vehicle. Salmonella Umbilo was detected in rocket salad, and later in baby spinach. The food isolates and clinical outbreak strain were genetically closely related. Both food items originated from the same company in Italy.

In October 2024, the first imported mpox clade Ib case was confirmed in Germany in an individual in their thirties returning from Rwanda. In this report we summarise the response from the public health service in North Rhine-Westphalia related to case management, contact tracing and institutional collaborations. Our findings highlight the importance of a coordinated public health response in the management of imported mpox cases and in preventing the transmission of mpox clade Ib in Germany and beyond.

BackgroundLate HIV diagnosis (CD4+ T-cell count < 350 cells/μL, or with an AIDS-defining event) remains a persistent challenge in Greece, indicating potential missed opportunities (MOs) for earlier testing.AimTo determine the frequency of HIV indicator conditions (ICs) preceding diagnosis and to quantify MOs for earlier testing at a nationwide level in Greece.MethodsThis multicentre retrospective study analysed data on 823 antiretroviral therapy-naive adults (≥ 18 years) diagnosed with HIV during 2019-21. Medical records were reviewed to identify pre-diagnosis healthcare contacts (HCCs) and ICs justifying HIV testing. Univariable and multivariable logistic regression identified factors associated with ≥ 1 MO. A Bayesian model estimated the time from seroconversion to diagnosis.ResultsAmong 517 participants with HCC data, 249 had ≥ 1 HCC. Of these, 59.0% (147/249) were late presenters. These cases had 365 HCCs, and 191 (52.3%) were MOs for testing. The most common ICs were sexually transmitted infections (39.8%; 76/191) and fever (11.0%; 21/191). Non-Greek origin was associated with lower odds of experiencing ≥ 1 MO (adjusted odds ratio: 0.48; 95% CI: 0.22─1.02), while higher education increased odds of MOs for early HIV diagnosis. Median time from seroconversion to diagnosis was 3.2 years for the full sample and 3.7 years for those with HCC, with about half of the latter reporting MOs post-estimated seroconversion. Recognising MOs would have potentially spared approximately 1 year of delay in diagnosis.ConclusionMOs for earlier HIV diagnosis were prevalent in Greece. Leveraging IC-guided testing and addressing barriers could support earlier diagnosis and treatment, limiting adverse health outcomes and preventing transmission.

After the start of the COVID-19 pandemic, a rapid rise in reported numbers and wide geographic spread of Candida auris-related invasive infections has been observed globally. However, the contemporary epidemiology of C. auris fungaemias in Greece remains unknown. An outbreak of C. auris bloodstream infections has been ongoing for almost 3 years in a Greek tertiary care academic hospital, with 89 C. auris-driven episodes appearing in five waves every 6-7 months following peaks in colonisation rates by 3-4 months. All isolates clustered in clade I and were genetically related, 84% were fluconazole-resistant and all were non-resistant to amphotericin B and echinocandins, except one pan-echinocandin-resistant isolate (FKS1S639F mutant) recovered from a patient on empiric therapy with anidulafungin. Notably, C. auris was in 2023 the most prevalent (34%) cause of candidaemia in our hospital. The accelerated and long-term transmission dynamics of C. auris fungaemia underscore the need for rigorous infection control measures, while antifungal stewardship is warranted to contain the selection of echinocandin-resistant isolates.