Eurosurveillance最新文献

To reduce antimicrobial resistance (AMR), pathogen-specific AMR burden data are crucial to guide target selection for research and development of vaccines and monoclonal antibodies (mAbs). We identified knowledge gaps through previously conducted systematic reviews, which informed a Delphi expert consultation on future AMR research priorities and harmonisation strategies to support data-driven decision-making. Consensus (≥80% agreement) on importance and feasibility of research topics was achieved in two rounds, involving 24 of 39 and 19 of 24 invited experts, respectively. Priority pathogens and resistance profiles for future research were identified: third generation cephalosporin-resistant Klebsiella pneumoniae and Escherichia coli, for bloodstream and urinary tract infections, respectively, and meticillin-resistant Staphylococcus aureus for surgical-site infections. Prioritised high-risk populations included surgical, haemato-oncological and transplant patients. Mortality and resource use were prioritised as health-economic outcomes. The importance of age-stratified data and inclusion of a non-infected comparator group were highlighted. This agenda provides guidance for future research to fill knowledge gaps and support data-driven selection of target pathogens and populations for new preventive and treatment strategies, specifically vaccines and mAbs, to effectively address the AMR burden in Europe. These research priorities are also relevant to improve the evidence base for future AMR burden estimates.

BackgroundThe National Surveillance for Invasive Meningococcal Disease (IMD) initiative started in Japan in April 2013. Multiple international mass gathering events have since been held in Japan, and the COVID-19 pandemic has occurred.AimWe summarised 10 years of national surveillance data for IMD in Japan to describe epidemiological characteristics of IMD and evaluate the influence of mass gatherings and the COVID-19 pandemic on IMD.MethodsUpon diagnosis of IMD, patient information and specimens were collected and reported to local health centres. We analysed the epidemiology of IMD cases reported between 1 April 2013 and 31 March 2023.ResultsAmong 274 cases reported (median age: 55 years; 55% male), no outbreaks related to mass gathering events were identified. The annual reported incidence of IMD was 0.001-0.039 cases per 100,000 individuals between 2014 and 2022, with a notable decrease after 2020. The overall case fatality rate was 12% (33/274). The most frequent serogroups were Y and B (46 and 17%). Multilocus sequence typing revealed a predominance of clonal complex (cc) 23, followed by cc2057, while cc11 was detected in eight cases.ConclusionThe reported incidence of IMD in Japan is low compared with high-endemic countries and decreased further during the COVID-19 pandemic. This unique epidemiology of IMD in Japan lacks a clear explanation. However, distribution of meningococcal strains, such as predominance of serogroup Y, could be a contributing factor. Maintaining high-quality surveillance, including of serogroups and sequence types, is crucial to manage and prevent future IMD cases in Japan effectively.

BackgroundRecent hepatitis A virus outbreaks in Europe affecting men who have sex with men (MSM) and ongoing hepatitis B virus transmission among MSM underscore the ongoing need for viral hepatitis prevention in this population.AimTo describe viral hepatitis knowledge and associated factors among MSM in the WHO European Region to inform targeted prevention.MethodsIn the European MSM Internet Survey (EMIS-2017), basic knowledge was defined as correctly identifying at least 4 of 5 statements about viral hepatitis and vaccination. We described basic knowledge by country. In a multilevel logistic regression model, we estimated adjusted odds ratios (aOR) with 95% confidence intervals (CI) for having basic knowledge and explanatory variables: sociodemographic characteristics, history of hepatitis C and/or HIV diagnosis, sexual orientation disclosure at last sexually transmitted infections (STI) test and outness.ResultsOf 113,884 participants across 43 WHO European Region countries, 68% demonstrated basic knowledge, ranging from 50% in Israel to 80% in the Netherlands. Basic knowledge was significantly associated with older age (≥ 40 years vs < 25 years, aOR: 2.9, 95% CI: 2.7-3.0), a history of hepatitis C and/or HIV diagnosis (aOR: 1.8, 95% CI: 1.7-1.9) and sexual orientation disclosure at last STI test (aOR: 1.3, 95% CI: 1.2-1.3), among other factors.ConclusionsWe found a knowledge disparity regarding viral hepatitis and hepatitis vaccination awareness among MSM across Europe, highlighting a need to address these gaps. A non-judgemental, accepting climate that allows individuals attending medical services to safely disclose their sexual orientation is fundamental to enable healthcare professionals to target information and preventative measures more effectively.

Serratia marcescens is an opportunistic pathogen with a propensity to cause nosocomial outbreaks, particularly in neonatal intensive care units (NICUs). We present a sustained outbreak spanning over 18 months (1 January 2022-29 August 2023) in a NICU in Antwerp, Belgium, affecting 61 neonates, identified through samples taken for diagnostic purposes and by rectal screening. Ten neonates were infected: five with lower respiratory tract infection, four with conjunctivitis and one fatal case with sepsis. In a logistic regression analysis, nursing in an incubator was significantly associated with acquisition of S. marcescens (odds ratio (OR): 2.99; 95% confidence interval (CI): 1.14-8.25; p < 0.05). Whole genome sequencing-based multilocus sequence typing (wgMLST) and core genome single nucleotide polymorphism (cgSNP) analysis of isolates from clinical (n = 4), screening (n = 52) and environmental samples (n = 8), identified eight clusters and five singletons not associated with the clusters. Although outbreak measures were successful in containing further spread within the ward during sudden surges when > 4 cases per week were identified (peak events), several peaks with different clonal clusters occurred. The emergence of similar outbreaks in Belgian hospitals underscores the need of continuous surveillance and NICU-specific infection prevention and control (IPC) measures.

BackgroundHepatitis A and B vaccinations are recommended for men who have sex with men (MSM), given their increased risk of infection. However, data on vaccination programmes are scarce.AimTo use information on vaccination recommendations and vaccine uptake among MSM in the WHO European Region to guide prevention.MethodsFrom a large pan-European MSM Internet Survey (EMIS-2017), we analysed data on self-reported hepatitis A and B vaccination status by age, education, financial coping, settlement size, outness (disclosure of sexual behaviour), migration history and diagnosis with hepatitis C or HIV, using multivariable logistic regression. Additionally, we collected information on national hepatitis A and B vaccination recommendations.ResultsWe present data of 113,884 MSM, median age 36 years (IQR: 27-47). Vaccination for hepatitis A and B was recommended and free for MSM in 7 and 18 of 43 countries, respectively. Of all respondents, 48% (n = 50,966) reported ever being vaccinated against hepatitis A, and 53% (n = 56,889) against hepatitis B. Odds for being vaccinated against hepatitis A increased with outness ('out to (almost) all' aOR: 1.78, 95% CI: 1.72-1.85 vs 'out to none') and were higher in countries where vaccination was recommended and free for MSM (aOR: 2.22, 95% CI: 1.29-3.82 vs 'no recommendation'). Results for hepatitis B were similar (outness: aOR: 1.81, 95% CI: 1.75-1.88 and MSM-specific vaccination recommendation: aOR: 2.44, 95% CI: 1.54-3.85).ConclusionLarge proportions of MSM in Europe remain vulnerable to hepatitis A and B, despite available vaccination. Implementation of MSM-specific vaccination recommendations and greater efforts to improve the societal climate for MSM are needed to address gaps in vaccine coverage.

BackgroundNon-university hospitals are the major provider of inpatient care in Germany, serving 89% of acute care hospital beds. Although surveillance data on antimicrobial use in hospitals are widely available, data on prescription quality are rare.AimWe aimed to provide an in-depth analysis of antimicrobial prescribing patterns and quality in southwest German non-university hospitals.MethodsDuring 2021, we performed three point prevalence surveys (PPS) in 10 non-university hospitals, representing ca 10% of hospital beds in the federal state of Baden-Württemberg (11 million inhabitants). Demographic and clinical information were collected. We assessed the overall performance of 14 validated process quality indicators (QI) covering infection diagnostics, antimicrobial therapy and documentation.ResultsOf 8,560 patients analysed, 2,861 (33%) received at least one antimicrobial. Most (2,789, 80%) antimicrobial prescriptions were for therapeutic indications. Most frequently prescribed agents were beta-lactam/beta-lactamase inhibitors (1,120, 40%) in therapeutic and cefuroxime (269, 37%) in prophylactic indications. According to the World Health Organization's Access, Watch, Reserve classification, the Access-to-Watch ratio was 0.73. Overall adherence to QIs was low and varied substantially (27-93%), with documentation, possible streamlining and switching to oral therapy exhibiting the lowest fulfilment rates (< 50%).ConclusionThe results indicate a need to improve antimicrobial prescribing quality in non-university hospitals. The high prevalence of antimicrobial use in our setting underlines the demand for sustainable antimicrobial stewardship programmes in this sector. Our QI-based PPS approach can be used to identify key targets for future antimicrobial stewardship interventions. The results indicate a need for further legislation on antimicrobial stewardship.

Acute myocarditis has risen among paediatric patients in Italy, with 65 clinically suspected cases reported by 12 centres in 2024, 32 linked to parvovirus B19 (B19V) infection. In 11 cases, B19V was not ruled out despite a concurrent European outbreak. Twenty-nine children required intensive care; eight fatalities occurred. While effective for both severe B19V infection and myocarditis, intravenous immunoglobulins were given in only one-third of cases. These findings highlight the need for timely diagnosis, stronger surveillance, and standardised treatment protocols.

BackgroundHepatitis C virus (HCV) infection is targeted for elimination as a public health threat by 2030. The World Health Organization goal for treatment uptake is ≥ 80% among cases diagnosed with an active HCV infection (RNA- or core antigen-positive), maintained for 2 years.AimTo calculate treatment uptake, time from diagnosis to treatment start and complete treatment dispensation among notified cases of HCV infection in Norway.MethodWe linked national data on notified cases diagnosed from 1990-2022 to dispensed prescriptions for HCV treatment from January 2004-February 2023 and data on residence status at the end of 2022. We described treatment uptake by demographic and epidemiological characteristics. We calculated the median number of months from diagnosis to treatment start by year. For direct-acting antiviral treatment periods, complete dispensation was based on the treatment and number of defined daily doses.ResultsAmong 12,178 notified cases that had an active infection at diagnosis and were still resident, 10,091 (83%) had received treatment. Uptake among resident cases was > 80% in 2021 and 2022. The median number of months from diagnosis to treatment decreased over time to 3 (interquartile range: 1-5) among cases diagnosed in 2021 and 2022. From 2015-22, 89-93% of direct-acting antiviral treatment periods annually had complete treatment dispensed.ConclusionNorway has achieved the elimination goal for treatment uptake among notified cases diagnosed with an active HCV infection. This highlights the benefit of a strategy that includes unrestricted, simplified and integrated treatment options.