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Jazmati N, Mischnik A, Kern WV, Behnke M, Chakraborty T, Dinkelacker A, Eisenbeis S, Falgenhauer J, Gastmeier P, Häcker G, Imirzalioglu C, Käding N, Kramme E, Peter S, Piepenbrock E, Rupp J, Schneider C, Schwab F, Seifert H, Tacconelli E, Trauth J, Biehl L, Walker SV, Rohde AM. Occurrence and trends of Clostridioides difficile infections in hospitalized patients: a prospective multi-centre cohort study in six German university hospitals, 2016-2020. J Hosp Infect 2024; 151:161-172. [PMID: 38969208 DOI: 10.1016/j.jhin.2024.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 05/30/2024] [Accepted: 06/09/2024] [Indexed: 07/07/2024]
Abstract
BACKGROUND For Clostridioides difficile infections (CDIs) in Germany no longitudinal multi-centre studies with standardized protocols for diagnosing CDI are available. Recent evaluations of general surveillance databases in Germany indicate a downward trend in CDI rates. We aimed to describe the actual burden and trends of CDI in German university hospitals from 2016 to 2020. METHODS Our study was a prospective multi-centre study covering six German university hospitals. We report the data in total, stratified by year, by medical specialty as well as by CDI severity. Multi-variable regression analyses were performed to assess risk factors for severe CDI. RESULTS We registered 3780 CDI cases among 1,436,352 patients. The median length of stay (LOS) of CDI cases was 20 days (interquartile range 11-37) compared with a general LOS of 4.2 days. In-hospital all-cause mortality in CDI patients was 11.7% (N = 444/3780), while mortality attributed to CDI was 0.4% (N = 16/3761). CDI recurrence rate was comparatively low at 7.2%. The incidence density of severe healthcare-associated healthcare onset (HAHO)-CDI showed a significant decrease from 2.25/10,000 patient days (pd) in 2016 to 1.49/10,000 pd in 2020 (trend calculation P=0.032). CONCLUSIONS Compared with a European point-prevalence study in 2013/2014, where overall CDI incidence density was 11.2 cases/10,000 pd in Germany (EUCLID), we see in our study halved overall CDI rates of 5.6 cases/10,000 pd in 2020. Our study shows current data on the distribution of CDI cases in German university hospitals and thus provides international comparative data on the key indicators of CDI.
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Affiliation(s)
- N Jazmati
- German Centre for Infection Research (DZIF), Germany; Institute for Medical Microbiology, Immunology and Hygiene, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany; Labor Dr. Wisplinghoff, Cologne, Germany.
| | - A Mischnik
- German Centre for Infection Research (DZIF), Germany; Department of Infectious Diseases and Microbiology, University Hospital Schleswig-Holstein/Campus Lübeck, Germany; Division of Infectious Diseases, Department of Medicine II, University Medical Centre and Faculty of Medicine, Albert-Ludwigs-University, Freiburg, Freiburg, Germany
| | - W V Kern
- Division of Infectious Diseases, Department of Medicine II, University Medical Centre and Faculty of Medicine, Albert-Ludwigs-University, Freiburg, Freiburg, Germany
| | - M Behnke
- German Centre for Infection Research (DZIF), Germany; Institute for Hygiene and Environmental Medicine, Charité - University Medicine Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany
| | - T Chakraborty
- German Centre for Infection Research (DZIF), Germany; Institute of Medical Microbiology, Justus Liebig University Giessen, Germany
| | - A Dinkelacker
- German Centre for Infection Research (DZIF), Germany; Institute of Medical Microbiology and Hygiene, University of Tübingen, Tübingen, Germany
| | - S Eisenbeis
- German Centre for Infection Research (DZIF), Germany; Division of Infectious Diseases, Department of Internal Medicine 1, University Hospital Tübingen, Tübingen, Germany
| | - J Falgenhauer
- German Centre for Infection Research (DZIF), Germany; Institute of Medical Microbiology, Justus Liebig University Giessen, Germany
| | - P Gastmeier
- German Centre for Infection Research (DZIF), Germany; Institute for Hygiene and Environmental Medicine, Charité - University Medicine Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany
| | - G Häcker
- German Centre for Infection Research (DZIF), Germany; Institute for Medical Microbiology and Hygiene, University Medical Centre Freiburg, University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - C Imirzalioglu
- German Centre for Infection Research (DZIF), Germany; Institute of Medical Microbiology, Justus Liebig University Giessen, Germany
| | - N Käding
- German Centre for Infection Research (DZIF), Germany; Department of Infectious Diseases and Microbiology, University Hospital Schleswig-Holstein/Campus Lübeck, Germany
| | - E Kramme
- German Centre for Infection Research (DZIF), Germany; Department of Infectious Diseases and Microbiology, University Hospital Schleswig-Holstein/Campus Lübeck, Germany
| | - S Peter
- German Centre for Infection Research (DZIF), Germany; Institute of Medical Microbiology and Hygiene, University of Tübingen, Tübingen, Germany
| | - E Piepenbrock
- German Centre for Infection Research (DZIF), Germany; Institute for Medical Microbiology, Immunology and Hygiene, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - J Rupp
- German Centre for Infection Research (DZIF), Germany; Department of Infectious Diseases and Microbiology, University Hospital Schleswig-Holstein/Campus Lübeck, Germany
| | - C Schneider
- German Centre for Infection Research (DZIF), Germany; Institute for Medical Microbiology and Hygiene, University Medical Centre Freiburg, University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - F Schwab
- German Centre for Infection Research (DZIF), Germany; Institute for Hygiene and Environmental Medicine, Charité - University Medicine Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany
| | - H Seifert
- German Centre for Infection Research (DZIF), Germany; Institute for Medical Microbiology, Immunology and Hygiene, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany; Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - E Tacconelli
- German Centre for Infection Research (DZIF), Germany; Division of Infectious Diseases, Department of Internal Medicine 1, University Hospital Tübingen, Tübingen, Germany
| | - J Trauth
- German Centre for Infection Research (DZIF), Germany; Department of Internal Medicine (Infectiology), Uniklinikum Giessen, Germany
| | - L Biehl
- German Centre for Infection Research (DZIF), Germany; Department I of Internal Medicine, University Hospital of Cologne, Germany
| | - S V Walker
- German Centre for Infection Research (DZIF), Germany; Institute for Medical Microbiology, Immunology and Hygiene, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany; RKH Regionale Kliniken Holding und Services GmbH, Institute for Clinical Microbiology and Hospital Hygiene, Hospital Ludwigsburg, Germany
| | - A M Rohde
- German Centre for Infection Research (DZIF), Germany; Institute for Hygiene and Environmental Medicine, Charité - University Medicine Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany
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2
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Castonguay AC, Chowdhury S, Shanta IS, Schrijver B, Schrijver R, Wang S, Soares Magalhães RJ. A Generalizable Prioritization Protocol for Climate-Sensitive Zoonotic Diseases. Trop Med Infect Dis 2024; 9:188. [PMID: 39195626 PMCID: PMC11359478 DOI: 10.3390/tropicalmed9080188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2024] [Revised: 08/15/2024] [Accepted: 08/19/2024] [Indexed: 08/29/2024] Open
Abstract
Emerging and re-emerging zoonotic diseases pose a significant threat to global health and economic security. This threat is further aggravated by amplifying drivers of change, including climate hazards and landscape alterations induced by climate change. Given the complex relationships between climate change and zoonotic disease health outcomes, a structured decision-making process is required to effectively identify pathogens of greatest concern to prioritize prevention and surveillance efforts. Here, we describe a workshop-based expert elicitation process in six steps to prioritize climate-sensitive zoonoses based on a structured approach to defining criteria for climate sensitivity. Fuzzy analytical hierarchy process methodology is used to analyze data provided by experts across human, animal, and environmental health sectors accounting for uncertainties at different stages of the prioritization process. We also present a new interactive expert elicitation interface that facilitates data collection and real-time visualization of prioritization results. The novel approach presented in this paper offers a generalized platform for prioritizing climate-sensitive zoonoses at a national or regional level. This allows for a structured decision-making support process when allocating limited financial and personnel resources to enhance preparedness and response to zoonotic diseases amplified by climate change.
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Affiliation(s)
- Adam C. Castonguay
- Queensland Alliance for One Health Sciences, School of Veterinary Sciences, The University of Queensland, St. Lucia, QLD 4072, Australia
| | - Sukanta Chowdhury
- International Centre for Diarrheal Diseases Research, Bangladesh (icddr,b), Dhaka 1213, Bangladesh; (S.C.); (I.S.S.)
| | - Ireen Sultana Shanta
- International Centre for Diarrheal Diseases Research, Bangladesh (icddr,b), Dhaka 1213, Bangladesh; (S.C.); (I.S.S.)
| | - Bente Schrijver
- VetEffect, 3723 BG Bilthoven, The Netherlands; (B.S.); (R.S.)
| | - Remco Schrijver
- VetEffect, 3723 BG Bilthoven, The Netherlands; (B.S.); (R.S.)
| | | | - Ricardo J. Soares Magalhães
- Queensland Alliance for One Health Sciences, School of Veterinary Sciences, The University of Queensland, St. Lucia, QLD 4072, Australia
- Children’s Health and Environment Program, UQ Children’s Health Research Centre, The University of Queensland, St. Lucia, QLD 4072, Australia
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3
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Wang KC, Chang CL, Wei SH, Chang CC. The study on setting priorities of zoonotic agents for medical preparedness and allocation of research resources. PLoS One 2024; 19:e0299527. [PMID: 38687751 PMCID: PMC11060589 DOI: 10.1371/journal.pone.0299527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 02/13/2024] [Indexed: 05/02/2024] Open
Abstract
The aim of this study is to develop a scoring platform to be used as a reference for both medical preparedness and research resource allocation in the prioritization of zoonoses. Using a case-control design, a comprehensive analysis of 46 zoonoses was conducted to identify factors influencing disease prioritization. This analysis provides a basis for constructing models and calculating prioritization scores for different diseases. The case group (n = 23) includes diseases that require immediate notification to health authorities within 24 hours of diagnosis. The control group (n = 23) includes diseases that do not require such immediate notification. Two different models were developed for primary disease prioritization: one model incorporated the four most commonly used prioritization criteria identified through an extensive literature review. The second model used the results of multiple logistic regression analysis to identify significant factors (with p-value less than 0.1) associated with 24-hour reporting, allowing for objective determination of disease prioritization criteria. These different modeling approaches may result in different weights and positive or negative effects of relevant factors within each model. Our study results highlight the variability of zoonotic disease information across time and geographic regions. It provides an objective platform to rank zoonoses and highlights the critical need for regular updates in the prioritization process to ensure timely preparedness. This study successfully established an objective framework for assessing the importance of zoonotic diseases. From a government perspective, it advocates applying principles that consider disease characteristics and medical resource preparedness in prioritization. The results of this study also emphasize the need for dynamic prioritization to effectively improve preparedness to prevent and control disease.
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Affiliation(s)
- Kung-Ching Wang
- Graduate Institute of Microbiology and Public Health, National Chung Hsing University, Taichung, Taiwan, R.O.C
| | - Chia-Lin Chang
- Department of Applied Economics, National Chung Hsing University, Taichung, Taiwan, R.O.C
| | - Sung-Hsi Wei
- Children’s Hospital, China Medical University, Taichung, Taiwan, R.O.C
| | - Chao-Chin Chang
- Graduate Institute of Microbiology and Public Health, National Chung Hsing University, Taichung, Taiwan, R.O.C
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Aebischer A, Mankertz A, Werner G, Suerbaum S. AL DISCRETO LETTORE: A short-list on Public Health Microbiology in Germany. Int J Med Microbiol 2024; 314:151617. [PMID: 38472007 DOI: 10.1016/j.ijmm.2024.151617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2024] Open
Affiliation(s)
- Anton Aebischer
- Department of Infectious Diseases, Robert-Koch-Institute, Nordufer 20, Berlin 13353, Germany.
| | - Annette Mankertz
- Department of Infectious Diseases, Robert-Koch-Institute, Nordufer 20, Berlin 13353, Germany
| | - Guido Werner
- Department of Infectious Diseases, Robert-Koch-Institute, Nordufer 20, Berlin 13353, Germany
| | - Sebastian Suerbaum
- Max von Pettenkofer-Institute, Pettenkoferstrasse 9a, München 80336, Germany
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Goldsmith J, Tomkovich S, Auniņš JG, McGovern BH, Mahoney JC, Hasson BR, McChalicher CWJ, Ege DS. End-to-end donor screening and manufacturing controls: complementary quality-based strategies to minimize patient risk for donor-derived microbiome therapeutics. Gut Microbes 2024; 16:2402550. [PMID: 39292598 DOI: 10.1080/19490976.2024.2402550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2024] [Revised: 08/26/2024] [Accepted: 09/04/2024] [Indexed: 09/20/2024] Open
Abstract
Advances in microbiome therapeutics have been motivated by a deeper understanding of the role that the gastrointestinal microbiome plays in human health and disease. The FDA approval of two stool-derived live biotherapeutic products (LBPs), REBYOTA® 150 mL enema (fecal microbiota, live-jslm; formerly RBX2660) and VOWST® oral capsules (fecal microbiota spores, live-brpk; formerly SER-109), for the prevention of recurrent CDI in adults following antibiotic treatment for recurrent CDI provides promise and insights for the development of LBPs for other diseases associated with microbiome dysfunction. Donor-derived products carry risk of disease transmission that must be mitigated through a robust donor screening program and downstream manufacturing controls. Most published recommendations for donor screening practices are prescriptive and do not include a systematic, risk-based approach for donor stool-derived products. A general framework for an end-to-end donor screening program is needed using risk management strategies for donor-derived microbiome therapeutic using a matrixed approach, combining the elements of donor screening with manufacturing controls that are designed to minimize risk to patients. A donor screening paradigm that incorporates medical history, physical examination, laboratory testing, and donor sample inspection are only the first steps in reducing risk of transmission of infectious agents. Manufacturing controls are the cornerstone of risk mitigation when screening unwittingly fails. Failure Mode and Effects Analysis (FMEA) can be used as a tool to assess for residual risk that requires further donor or manufacturing controls. Together, a well-reasoned donor program and manufacturing controls are complementary strategies that must be revisited and reexamined frequently with constant vigilance to mitigate risk to patients. In the spirit of full disclosure and informed consent, physicians should discuss any limitations in the donor screening and manufacturing processes with their patients prior to treatment with microbiome-based therapeutics.
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Affiliation(s)
- Jason Goldsmith
- Product Development, Quality, and Supply (PDQS), Seres Therapeutics, Inc., Cambridge, MA, USA
| | - Sarah Tomkovich
- Product Development, Quality, and Supply (PDQS), Seres Therapeutics, Inc., Cambridge, MA, USA
| | - John G Auniņš
- Product Development, Quality, and Supply (PDQS), Seres Therapeutics, Inc., Cambridge, MA, USA
| | - Barbara H McGovern
- Product Development, Quality, and Supply (PDQS), Seres Therapeutics, Inc., Cambridge, MA, USA
| | - Jennifer C Mahoney
- Product Development, Quality, and Supply (PDQS), Seres Therapeutics, Inc., Cambridge, MA, USA
| | - Brooke R Hasson
- Product Development, Quality, and Supply (PDQS), Seres Therapeutics, Inc., Cambridge, MA, USA
| | | | - David S Ege
- Product Development, Quality, and Supply (PDQS), Seres Therapeutics, Inc., Cambridge, MA, USA
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6
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Kostirko D, Zhao J, Lavigne M, Hermant B, Totten L. A rapid review of best practices in the development of risk registers for public health emergency management. Front Public Health 2023; 11:1200438. [PMID: 38098833 PMCID: PMC10720617 DOI: 10.3389/fpubh.2023.1200438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 11/14/2023] [Indexed: 12/17/2023] Open
Abstract
Introduction Public health organizations (PHO) must prepare to respond to a range of emergencies. This represents an ongoing challenge in an increasingly connected world, where the scope, complexity, and diversity of public health threats (PHT) have expanded, as exemplified by the COVID-19 pandemic. Risk registers (RR) offer a framework for identifying and managing threats, which can be employed by PHOs to better identify and characterize health threats. The aim of this review is to establish best practices (BP) for the development of RRs within Public Health Emergency Management (PHEM). Methods In partnership with a librarian from Health Canada (HC), and guided by the Cochrane Rapid Review Guideline, journal articles were retrieved through MEDLINE, and a comprehensive search strategy was applied to obtain grey literature through various databases. Articles were limited to those that met the following criteria: published on or after January 1, 2010, published in the English language and published within an Organisation for Economic Co-operation and Development setting. Results 57 articles were included for synthesis. 41 papers specifically discussed the design of RRs. The review identified several guidelines to establish RRs in PHEM, including forward-looking, multidisciplinary, transparent, fit-for-purpose, and utilizing a systems approach to analyze and prioritize threats. Expert consultations, literature reviews, and prioritization methods such as multi-criteria-decision-analysis (MCDA) are often used to support the development of RRs. A minimum five-year-outlook is applied to assess PHTs, which are revisited yearly, and iteratively revised as new knowledge arises. Discussion Based upon this review, RRs offer a systems approach to PHEM that can be expanded to facilitate the analysis of disparate threats. These approaches should factor in the multidimensionality of threats, need for multi-sectoral inputs, and use of vulnerability analyses that consider inherent drivers. Further research is needed to understand how drivers modify threats. The BPs and recommendations highlighted in our research can be adopted in the practice of PHEM to characterize the public health (PH) risk environment at a given point in time and support PHOs policy and decision-making.
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Affiliation(s)
- Danylo Kostirko
- Risk and Capability Assessment Unit, Public Health Agency of Canada, Ottawa, ON, Canada
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7
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Tamayo Cuartero C, Radford AD, Szilassy E, Newton JR, Sánchez-Vizcaíno F. Stakeholder opinion-led study to identify canine priority diseases for surveillance and control in the UK. Vet Rec 2023; 193:e3167. [PMID: 37415378 DOI: 10.1002/vetr.3167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 05/17/2023] [Accepted: 05/26/2023] [Indexed: 07/08/2023]
Abstract
BACKGROUND Many pathogens cause disease in dogs; however, meaningful surveillance in small companion animals is often only possible for the most impactful diseases. We describe the first stakeholder opinion-led approach to identify which canine infectious diseases should be prioritised for inclusion in surveillance and control strategies in the UK. METHODS Participants were identified through a stakeholder analysis. A multicriteria decision analysis was undertaken to establish and weight epidemiological criteria for evaluating diseases, and a Delphi technique was employed to achieve a consensus among participants on the top-priority canine diseases. RESULTS Nineteen stakeholders from multiple backgrounds participated in this study. Leptospirosis and parvovirus were identified as the top two endemic diseases of concern, while leishmaniosis and babesiosis were the top two exotic diseases. Respiratory and gastrointestinal diseases were identified as the top two syndromes of concern. LIMITATIONS Due to the COVID-19 pandemic, the number of participants was reduced. Despite this, a representative multidisciplinary sample of relevant stakeholders contributed to the present study. CONCLUSIONS Findings from this study are being used to inform the development of a future UK-wide epidemic response strategy. This methodology could provide a blueprint for other countries.
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Sui X, Yang X, Luo M, Wang H, Liu Q, Sun H, Jin Y, Wu Y, Bai X, Xiong Y. Characteristics of Shiga Toxin-Producing Escherichia coli Circulating in Asymptomatic Food Handlers. Toxins (Basel) 2023; 15:640. [PMID: 37999503 PMCID: PMC10675304 DOI: 10.3390/toxins15110640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 10/22/2023] [Accepted: 10/31/2023] [Indexed: 11/25/2023] Open
Abstract
Shiga toxin-producing Escherichia coli (STEC) is a foodborne zoonotic pathogen that causes diarrhea, hemorrhagic colitis (HC), and hemolytic uremic syndrome (HUS) worldwide. Since the infection can be asymptomatic, the circulation of STEC in some asymptomatic carriers, especially in healthy-food-related professionals, is not yet well understood. In this study, a total of 3987 anal swab samples from asymptomatic food handlers were collected, and ten swabs recovered STEC strains (0.251%). Of the ten STEC isolates, seven serotypes and eight sequence types (ST) were determined using whole genome sequencing (WGS). Two stx1 subtypes (stx1a and stx1c) and four stx2 subtypes (stx2a, stx2b, stx2d, and stx2e) were detected. Seven different insertion sites were found in fourteen Stx prophages, and the dmsB and yfhL were the newly identified insertion sites. The ten strains showed the variable Stx transcription levels after the mitomycin C induction. The whole-genome phylogeny indicated that the strains from the asymptomatic food handlers were genetically distant from the strains of HUS patients. The STEC isolates circulating in asymptomatic carriers might pose a low potential to cause disease.
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Affiliation(s)
- Xinxia Sui
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Xi Yang
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Ming Luo
- Yulin Center for Disease Control and Prevention, Yulin 537000, China
| | - Hua Wang
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Qian Liu
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Hui Sun
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Yujuan Jin
- Longgang Center for Disease Control and Prevention, Shenzhen 518172, China
| | - Yannong Wu
- Yulin Center for Disease Control and Prevention, Yulin 537000, China
| | - Xiangning Bai
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
- Division of Laboratory Medicine, Oslo University Hospital, 0372 Oslo, Norway
| | - Yanwen Xiong
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
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9
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Rohde AM, Mischnik A, Behnke M, Dinkelacker A, Eisenbeis S, Falgenhauer J, Gastmeier P, Häcker G, Herold S, Imirzalioglu C, Käding N, Kramme E, Peter S, Piepenbrock E, Rupp J, Schneider C, Schwab F, Seifert H, Steib-Bauert M, Tacconelli E, Trauth J, Vehreschild MJGT, Walker SV, Kern WV, Jazmati N. Association of ward-level antibiotic consumption with healthcare-associated Clostridioides difficile infections: an ecological study in five German university hospitals, 2017-2019. J Antimicrob Chemother 2023; 78:2274-2282. [PMID: 37527398 DOI: 10.1093/jac/dkad232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 07/09/2023] [Indexed: 08/03/2023] Open
Abstract
OBJECTIVES To analyse the influence of antibiotic consumption on healthcare-associated healthcare onset (HAHO) Clostridioides difficile infection (CDI) in a German university hospital setting. METHODS Monthly ward-level antibiotic consumption measured in DDD/100 patient days (pd) and CDI surveillance data from five university hospitals in the period 2017 through 2019 were analysed. Uni- and multivariable analyses were performed with generalized estimating equation models. RESULTS A total of 225 wards with 7347 surveillance months and 4 036 602 pd participated. With 1184 HAHO-CDI cases, there was a median incidence density of 0.17/1000 pd (IQR 0.03-0.43) across all specialties, with substantial differences among specialties. Haematology-oncology wards showed the highest median incidence density (0.67/1000 pd, IQR 0.44-1.01), followed by medical ICUs (0.45/1000 pd, IQR 0.27-0.73) and medical general wards (0.32/1000 pd, IQR 0.18-0.53). Multivariable analysis revealed carbapenem (mostly meropenem) consumption to be the only antibiotic class associated with increased HAHO-CDI incidence density. Each carbapenem DDD/100 pd administered increased the HAHO-CDI incidence density by 1.3% [incidence rate ratio (IRR) 1.013; 95% CI 1.006-1.019]. Specialty-specific analyses showed this influence only to be valid for haematological-oncological wards. Overall, factors like ward specialty (e.g. haematology-oncology ward IRR 2.961, 95% CI 2.203-3.980) or other CDI cases on ward had a stronger influence on HAHO-CDI incidence density (e.g. community-associated CDI or unknown association case in same month IRR 1.476, 95% CI 1.242-1.755) than antibiotic consumption. CONCLUSIONS In the German university hospital setting, monthly ward-level carbapenem consumption seems to increase the HAHO-CDI incidence density predominantly on haematological-oncological wards. Furthermore, other patient-specific factors seem to be equally important to control HAHO-CDI.
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Affiliation(s)
- Anna M Rohde
- German Centre for Infection Research (DZIF), Healthcare-Associated and Antibiotic-Resistant Bacterial Infections, Braunschweig, Germany
- Institute for Hygiene and Environmental Medicine, Charité - University Medicine Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Hindenburgdamm 27, 12203 Berlin, Germany
| | - Alexander Mischnik
- German Centre for Infection Research (DZIF), Healthcare-Associated and Antibiotic-Resistant Bacterial Infections, Braunschweig, Germany
- Department of Infectious Diseases and Microbiology, University Hospital Schleswig-Holstein/Campus Lübeck, Lübeck, Germany
- Division of Infectious Diseases, Department of Medicine II, University Medical Centre and Faculty of Medicine, Albert-Ludwigs-University Freiburg, Freiburg, Germany
| | - Michael Behnke
- German Centre for Infection Research (DZIF), Healthcare-Associated and Antibiotic-Resistant Bacterial Infections, Braunschweig, Germany
- Institute for Hygiene and Environmental Medicine, Charité - University Medicine Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Hindenburgdamm 27, 12203 Berlin, Germany
| | - Ariane Dinkelacker
- German Centre for Infection Research (DZIF), Healthcare-Associated and Antibiotic-Resistant Bacterial Infections, Braunschweig, Germany
- Institute of Medical Microbiology and Hygiene, University of Tübingen, Tübingen, Germany
| | - Simone Eisenbeis
- German Centre for Infection Research (DZIF), Healthcare-Associated and Antibiotic-Resistant Bacterial Infections, Braunschweig, Germany
- Division of Infectious Diseases, Department of Internal Medicine 1, University Hospital Tübingen, Tübingen, Germany
| | - Jane Falgenhauer
- German Centre for Infection Research (DZIF), Healthcare-Associated and Antibiotic-Resistant Bacterial Infections, Braunschweig, Germany
- Institute of Medical Microbiology, Justus Liebig University Giessen, Giessen, Germany
| | - Petra Gastmeier
- German Centre for Infection Research (DZIF), Healthcare-Associated and Antibiotic-Resistant Bacterial Infections, Braunschweig, Germany
- Institute for Hygiene and Environmental Medicine, Charité - University Medicine Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Hindenburgdamm 27, 12203 Berlin, Germany
| | - Georg Häcker
- German Centre for Infection Research (DZIF), Healthcare-Associated and Antibiotic-Resistant Bacterial Infections, Braunschweig, Germany
- Institute for Medical Microbiology and Hygiene, University Medical Centre Freiburg, University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - Susanne Herold
- German Centre for Infection Research (DZIF), Healthcare-Associated and Antibiotic-Resistant Bacterial Infections, Braunschweig, Germany
- University Hospital Giessen and Marburg, Department of Medicine V (Internal Medicine, Infectious Diseases and Infection Control), Justus-Liebig-University Giessen, Giessen, Germany, member of the German Centre for Lung Research (DZL), member of the German Centre for Infection Research (DZIF) Department of Internal Medicine (Infectiology)
| | - Can Imirzalioglu
- German Centre for Infection Research (DZIF), Healthcare-Associated and Antibiotic-Resistant Bacterial Infections, Braunschweig, Germany
- Institute of Medical Microbiology, Justus Liebig University Giessen, Giessen, Germany
| | - Nadja Käding
- German Centre for Infection Research (DZIF), Healthcare-Associated and Antibiotic-Resistant Bacterial Infections, Braunschweig, Germany
- Department of Infectious Diseases and Microbiology, University Hospital Schleswig-Holstein/Campus Lübeck, Lübeck, Germany
| | - Evelyn Kramme
- German Centre for Infection Research (DZIF), Healthcare-Associated and Antibiotic-Resistant Bacterial Infections, Braunschweig, Germany
- Department of Infectious Diseases and Microbiology, University Hospital Schleswig-Holstein/Campus Lübeck, Lübeck, Germany
| | - Silke Peter
- German Centre for Infection Research (DZIF), Healthcare-Associated and Antibiotic-Resistant Bacterial Infections, Braunschweig, Germany
- Institute of Medical Microbiology and Hygiene, University of Tübingen, Tübingen, Germany
| | - Ellen Piepenbrock
- German Centre for Infection Research (DZIF), Healthcare-Associated and Antibiotic-Resistant Bacterial Infections, Braunschweig, Germany
- Institute for Medical Microbiology, Immunology and Hygiene, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Jan Rupp
- German Centre for Infection Research (DZIF), Healthcare-Associated and Antibiotic-Resistant Bacterial Infections, Braunschweig, Germany
- Department of Infectious Diseases and Microbiology, University Hospital Schleswig-Holstein/Campus Lübeck, Lübeck, Germany
| | - Christian Schneider
- German Centre for Infection Research (DZIF), Healthcare-Associated and Antibiotic-Resistant Bacterial Infections, Braunschweig, Germany
- Institute for Medical Microbiology and Hygiene, University Medical Centre Freiburg, University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - Frank Schwab
- German Centre for Infection Research (DZIF), Healthcare-Associated and Antibiotic-Resistant Bacterial Infections, Braunschweig, Germany
- Institute for Hygiene and Environmental Medicine, Charité - University Medicine Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Hindenburgdamm 27, 12203 Berlin, Germany
| | - Harald Seifert
- German Centre for Infection Research (DZIF), Healthcare-Associated and Antibiotic-Resistant Bacterial Infections, Braunschweig, Germany
- Institute for Medical Microbiology, Immunology and Hygiene, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Michaela Steib-Bauert
- German Centre for Infection Research (DZIF), Healthcare-Associated and Antibiotic-Resistant Bacterial Infections, Braunschweig, Germany
- Division of Infectious Diseases, Department of Medicine II, University Medical Centre and Faculty of Medicine, Albert-Ludwigs-University Freiburg, Freiburg, Germany
| | - Evelina Tacconelli
- German Centre for Infection Research (DZIF), Healthcare-Associated and Antibiotic-Resistant Bacterial Infections, Braunschweig, Germany
- Division of Infectious Diseases, Department of Internal Medicine 1, University Hospital Tübingen, Tübingen, Germany
| | - Janina Trauth
- German Centre for Infection Research (DZIF), Healthcare-Associated and Antibiotic-Resistant Bacterial Infections, Braunschweig, Germany
- University Hospital Giessen and Marburg, Department of Medicine V (Internal Medicine, Infectious Diseases and Infection Control), Justus-Liebig-University Giessen, Giessen, Germany, member of the German Centre for Lung Research (DZL), member of the German Centre for Infection Research (DZIF) Department of Internal Medicine (Infectiology)
| | - Maria J G T Vehreschild
- German Centre for Infection Research (DZIF), Healthcare-Associated and Antibiotic-Resistant Bacterial Infections, Braunschweig, Germany
- Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany
- Department of Internal Medicine, Infectious Diseases, Goethe University, Frankfurt am Main, Germany
| | - Sarah V Walker
- German Centre for Infection Research (DZIF), Healthcare-Associated and Antibiotic-Resistant Bacterial Infections, Braunschweig, Germany
- Institute for Medical Microbiology, Immunology and Hygiene, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Winfried V Kern
- German Centre for Infection Research (DZIF), Healthcare-Associated and Antibiotic-Resistant Bacterial Infections, Braunschweig, Germany
- Division of Infectious Diseases, Department of Medicine II, University Medical Centre and Faculty of Medicine, Albert-Ludwigs-University Freiburg, Freiburg, Germany
| | - Nathalie Jazmati
- German Centre for Infection Research (DZIF), Healthcare-Associated and Antibiotic-Resistant Bacterial Infections, Braunschweig, Germany
- Institute for Medical Microbiology, Immunology and Hygiene, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Labor Dr. Wisplinghoff, Cologne, Germany
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10
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Salzberger B, Mellmann A, Bludau A, Ciesek S, Corman V, Dilthey A, Donker T, Eckmanns T, Egelkamp R, Gatermann SG, Grundmann H, Häcker G, Kaase M, Lange B, Mielke M, Pletz MW, Semmler T, Thürmer A, Wieler LH, Wolff T, Widmer AF, Scheithauer S. An appeal for strengthening genomic pathogen surveillance to improve pandemic preparedness and infection prevention: the German perspective. Infection 2023; 51:805-811. [PMID: 37129842 PMCID: PMC10152431 DOI: 10.1007/s15010-023-02040-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 04/13/2023] [Indexed: 05/03/2023]
Abstract
The SARS-CoV-2 pandemic has highlighted the importance of viable infection surveillance and the relevant infrastructure. From a German perspective, an integral part of this infrastructure, genomic pathogen sequencing, was at best fragmentary and stretched to its limits due to the lack or inefficient use of equipment, human resources, data management and coordination. The experience in other countries has shown that the rate of sequenced positive samples and linkage of genomic and epidemiological data (person, place, time) represent important factors for a successful application of genomic pathogen surveillance. Planning, establishing and consistently supporting adequate structures for genomic pathogen surveillance will be crucial to identify and combat future pandemics as well as other challenges in infectious diseases such as multi-drug resistant bacteria and healthcare-associated infections. Therefore, the authors propose a multifaceted and coordinated process for the definition of procedural, legal and technical standards for comprehensive genomic pathogen surveillance in Germany, covering the areas of genomic sequencing, data collection and data linkage, as well as target pathogens. A comparative analysis of the structures established in Germany and in other countries is applied. This proposal aims to better tackle epi- and pandemics to come and take action from the "lessons learned" from the SARS-CoV-2 pandemic.
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Affiliation(s)
- Bernd Salzberger
- Department for Infection Control and Infectious Diseases, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany.
| | - Alexander Mellmann
- Institute for Hygiene, University Hospital Münster, Robert-Koch-Straße 41, 48149, Münster, Germany.
| | - Anna Bludau
- Department for Infection Control and Infectious Diseases, University Medical Center (UMG), Georg-August University Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Germany
| | - Sandra Ciesek
- Institute of Medical Virology, University Hospital Frankfurt, Goethe University, Frankfurt Am Main, Germany
| | - Victor Corman
- Institute of Virology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Alexander Dilthey
- Institute of Medical Microbiology and Hospital Hygiene, University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Tjibbe Donker
- Institute for Infection Prevention and Hospital Epidemiology, University Medical Center Freiburg, Freiburg, Germany
| | | | - Richard Egelkamp
- Next Generation Sequencing, Public Health Agency of Lower Saxony, Hanover, Germany
| | - Sören G Gatermann
- Department of Medical Microbiology, Ruhr University Bochum, Bochum, Germany
| | - Hajo Grundmann
- Institute for Infection Prevention and Hospital Epidemiology, University Medical Center Freiburg, Freiburg, Germany
| | - Georg Häcker
- Faculty of Medicine, Institute of Medical Microbiology and Hygiene, Medical Centre University of Freiburg, Freiburg, Germany
| | - Martin Kaase
- Department for Infection Control and Infectious Diseases, University Medical Center (UMG), Georg-August University Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Germany
| | - Berit Lange
- Department of Epidemiology, Helmholtz Centre for Infection Research, Brunswick, Germany
| | | | - Mathias W Pletz
- Institute of Infectious Diseases and Infection Control, University Hospital, Jena, Germany
| | | | | | | | | | - Andreas F Widmer
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
| | - Simone Scheithauer
- Department for Infection Control and Infectious Diseases, University Medical Center (UMG), Georg-August University Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Germany.
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11
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Gentry Z, Zhao L, Faust RA, David RE, Norton J, Xagoraraki I. Wastewater surveillance beyond COVID-19: a ranking system for communicable disease testing in the tri-county Detroit area, Michigan, USA. Front Public Health 2023; 11:1178515. [PMID: 37333521 PMCID: PMC10272568 DOI: 10.3389/fpubh.2023.1178515] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 05/12/2023] [Indexed: 06/20/2023] Open
Abstract
Introduction Throughout the coronavirus disease 2019 (COVID-19) pandemic, wastewater surveillance has been utilized to monitor the disease in the United States through routine national, statewide, and regional monitoring projects. A significant canon of evidence was produced showing that wastewater surveillance is a credible and effective tool for disease monitoring. Hence, the application of wastewater surveillance can extend beyond monitoring SARS-CoV-2 to encompass a diverse range of emerging diseases. This article proposed a ranking system for prioritizing reportable communicable diseases (CDs) in the Tri-County Detroit Area (TCDA), Michigan, for future wastewater surveillance applications at the Great Lakes Water Authority's Water Reclamation Plant (GLWA's WRP). Methods The comprehensive CD wastewater surveillance ranking system (CDWSRank) was developed based on 6 binary and 6 quantitative parameters. The final ranking scores of CDs were computed by summing the multiplication products of weighting factors for each parameter, and then were sorted based on decreasing priority. Disease incidence data from 2014 to 2021 were collected for the TCDA. Disease incidence trends in the TCDA were endowed with higher weights, prioritizing the TCDA over the state of Michigan. Results Disparities in incidences of CDs were identified between the TCDA and state of Michigan, indicating epidemiological differences. Among 96 ranked CDs, some top ranked CDs did not present relatively high incidences but were prioritized, suggesting that such CDs require significant attention by wastewater surveillance practitioners, despite their relatively low incidences in the geographic area of interest. Appropriate wastewater sample concentration methods are summarized for the application of wastewater surveillance as per viral, bacterial, parasitic, and fungal pathogens. Discussion The CDWSRank system is one of the first of its kind to provide an empirical approach to prioritize CDs for wastewater surveillance, specifically in geographies served by centralized wastewater collection in the area of interest. The CDWSRank system provides a methodological tool and critical information that can help public health officials and policymakers allocate resources. It can be used to prioritize disease surveillance efforts and ensure that public health interventions are targeted at the most potentially urgent threats. The CDWSRank system can be easily adopted to geographical locations beyond the TCDA.
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Affiliation(s)
- Zachary Gentry
- Department of Civil and Environmental Engineering, Michigan State University, East Lansing, MI, United States
| | - Liang Zhao
- Department of Civil and Environmental Engineering, Michigan State University, East Lansing, MI, United States
| | | | - Randy E. David
- Wayne State University School of Medicine, Detroit, MI, United States
| | - John Norton
- Great Lakes Water Authority, Detroit, MI, United States
| | - Irene Xagoraraki
- Department of Civil and Environmental Engineering, Michigan State University, East Lansing, MI, United States
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12
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Atwal S, Schmider J, Buchberger B, Boshnakova A, Cook R, White A, El Bcheraoui C. Prioritisation processes for programme implementation and evaluation in public health: A scoping review. Front Public Health 2023; 11:1106163. [PMID: 37050947 PMCID: PMC10083497 DOI: 10.3389/fpubh.2023.1106163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 03/09/2023] [Indexed: 03/29/2023] Open
Abstract
BackgroundProgramme evaluation is an essential and systematic activity for improving public health programmes through useful, feasible, ethical, and accurate methods. Finite budgets require prioritisation of which programmes can be funded, first, for implementation, and second, evaluation. While criteria for programme funding have been discussed in the literature, a similar discussion around criteria for which programmes are to be evaluated is limited. We reviewed the criteria and frameworks used for prioritisation in public health more broadly, and those used in the prioritisation of programmes for evaluation. We also report on stakeholder involvement in prioritisation processes, and evidence on the use and utility of the frameworks or sets of criteria identified. Our review aims to inform discussion around which criteria and domains are best suited for the prioritisation of public health programmes for evaluation.MethodsWe reviewed the peer-reviewed literature through OVID MEDLINE (PubMed) on 11 March 2022. We also searched the grey literature through Google and across key websites including World Health Organization (WHO), US Centers for Disease Control and Prevention (CDC), European Centre for Disease Prevention and Control (ECDC), and the International Association of National Public Health Institutes (IANPHI) (14 March 2022). Articles were limited to those published between 2002 and March 2022, in English, French or German.ResultsWe extracted over 300 unique criteria from 40 studies included in the analysis. These criteria were categorised into 16 high-level conceptual domains to allow synthesis of the findings. The domains most frequently considered in the studies were “burden of disease” (33 studies), “social considerations” (30 studies) and “health impacts of the intervention” (28 studies). We only identified one paper which proposed criteria for use in the prioritisation of public health programmes for evaluation. Few prioritisation frameworks had evidence of use outside of the setting in which they were developed, and there was limited assessment of their utility. The existing evidence suggested that prioritisation frameworks can be used successfully in budget allocation, and have been reported to make prioritisation more robust, systematic, transparent, and collaborative.ConclusionOur findings reflect the complexity of prioritisation in public health. Development of a framework for the prioritisation of programmes to be evaluated would fill an evidence gap, as would formal assessment of its utility. The process itself should be formal and transparent, with the aim of engaging a diverse group of stakeholders including patient/public representatives.
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Affiliation(s)
- Shaileen Atwal
- Economist Impact, Health Policy and Insights, London, United Kingdom
| | - Jessica Schmider
- Economist Impact, Health Policy and Insights, London, United Kingdom
| | - Barbara Buchberger
- Evidence-Based Public Health, Centre for International Health Protection, Robert Koch Institute, Berlin, Germany
| | - Anelia Boshnakova
- Economist Impact, Health Policy and Insights, London, United Kingdom
| | - Rob Cook
- Economist Impact, Health Policy and Insights, London, United Kingdom
| | - Alicia White
- Economist Impact, Health Policy and Insights, London, United Kingdom
| | - Charbel El Bcheraoui
- Evidence-Based Public Health, Centre for International Health Protection, Robert Koch Institute, Berlin, Germany
- *Correspondence: Charbel El Bcheraoui,
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13
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Khan T, Raza S, Lawrence AJ. Medicinal Utility of Thiosemicarbazones with Special Reference to Mixed Ligand and Mixed Metal Complexes: A Review. RUSS J COORD CHEM+ 2022. [DOI: 10.1134/s1070328422600280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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14
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Schneider S, Ettenauer J, Pap IJ, Aspöck C, Walochnik J, Brandl M. Main Metabolites of Pseudomonas aeruginosa: A Study of Electrochemical Properties. SENSORS (BASEL, SWITZERLAND) 2022; 22:s22134694. [PMID: 35808191 PMCID: PMC9269063 DOI: 10.3390/s22134694] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 06/16/2022] [Accepted: 06/17/2022] [Indexed: 06/03/2023]
Abstract
Pseudomonas aeruginosa is a ubiquitously distributed soil and water bacterium and is considered an opportunistic pathogen in hospitals. In cystic fibrosis patients, for example, infections with P. aeruginosa can be severe and often lead to chronic or even fatal pneumonia. Therefore, rapid detection and further identification are of major importance in hospital hygiene and infection control. This work shows the electrochemical properties of five P. aeruginosa key metabolites considering their potential use as specific signaling agents in an electrochemical sensor system. The pure solutes of pyocyanin (PYO), Pseudomonas quinolone signal (PQS), pyochelin (PCH), 2-heptyl-4-hydroxyquinoline (HHQ), and 2-heptyl-4-hydroxyquinoline N-oxide (HQNO) were analyzed by different electrochemical techniques (cyclic and square wave voltammetry) and measured using a Gamry Reference 600+ potentiostat. Screen-printed electrodes (DropSens DRP110; carbon working and counter, silver reference electrode) were used to determine signal specificities, detection limits, as well as pH dependencies of the substances. All of the compounds were electrochemically inducible with well-separated oxidation and/or reduction peaks at specific peak potentials relative to the reference electrode. Additionally, all analytes exhibited linear concentration dependency in ranges classically reported in the literature. The demonstration of these properties is a promising step toward direct multiplexed detection of P. aeruginosa in environmental and clinical samples and thus, can make a significant contribution to public health and safety.
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Affiliation(s)
- Sylvia Schneider
- Department for Integrated Sensor Systems, University for Continuing Education Krems, 3500 Krems, Austria; (J.E.); (M.B.)
| | - Jörg Ettenauer
- Department for Integrated Sensor Systems, University for Continuing Education Krems, 3500 Krems, Austria; (J.E.); (M.B.)
- Department of Biotechnology, University of Natural Resources and Life Sciences, 1190 Vienna, Austria
| | - Ildiko-Julia Pap
- Clinical Institute for Hygiene and Microbiology, University Hospital St. Poelten, 3100 Sankt Poelten, Austria; (I.-J.P.); (C.A.)
- Karl Landsteiner University of Health Sciences, 3500 Krems, Austria
| | - Christoph Aspöck
- Clinical Institute for Hygiene and Microbiology, University Hospital St. Poelten, 3100 Sankt Poelten, Austria; (I.-J.P.); (C.A.)
- Karl Landsteiner University of Health Sciences, 3500 Krems, Austria
| | - Julia Walochnik
- Institute of Specific Prophylaxis and Tropical Medicine, Medical University of Vienna, 1090 Vienna, Austria;
| | - Martin Brandl
- Department for Integrated Sensor Systems, University for Continuing Education Krems, 3500 Krems, Austria; (J.E.); (M.B.)
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15
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Skoog Ståhlgren G, Grape M, Edlund C. The Swedish model for prioritising research on the use of antibiotics: Aligning public funding with research gaps. Health Policy 2022; 126:725-730. [DOI: 10.1016/j.healthpol.2022.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 09/03/2021] [Accepted: 05/20/2022] [Indexed: 11/04/2022]
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16
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Zhao J, Smith T, Lavigne M, Aenishaenslin C, Cox R, Fazil A, Johnson A, Sanchez J, Hermant B. A Rapid Literature Review of Multi-Criteria Decision Support Methods in the Context of One Health for All-Hazards Threat Prioritization. Front Public Health 2022; 10:861594. [PMID: 35493347 PMCID: PMC9051240 DOI: 10.3389/fpubh.2022.861594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 03/11/2022] [Indexed: 11/24/2022] Open
Abstract
Background Multi-Criteria Decision Analysis (MCDA) is a decision support tool that can be used in public health emergency management. The use of a One Health lens in MCDA can support the prioritization of threats and interventions which cut across the human, animal, and environmental domains. Previous literature reviews have focused on creating a snapshot of MCDA methodological trends. Our study provides an update to the MCDA methods literature with key considerations from a One Health perspective and addresses the application of MCDA in an all-hazards decision-making context. Methods We conducted a literature search on MEDLINE, EMBASE, SCOPUS, the CAB database, and a limited online gray literature search in partnership with a librarian from Health Canada. Articles were limited to those published in the year 2010 or later in a high-income setting (OECD member countries). Results Sixty-two articles were included for synthesis. Of these articles, most were Canadian studies (20%); and prioritized health risks, threats, and interventions in the human domain (69%). Six commonly used prioritization criteria were identified: threat, health, intervention, strategic, social, and economic impact. Stakeholders were engaged in 85% of studies and commonly consisted of government groups, non-governmental groups, subject matter experts, and the public. While most articles (65%) included elements of One Health based on our definition, only 5 studies (9%) explicitly acknowledged One Health as a guiding principle for the study. Forty seven percentage of studies noted that MCDA was beneficial in supporting the decision-making process. Conclusion Current literature on health prioritization presents some variability in the depth of integration of the One Health framework and on the use of various MCDA methodologies given prioritization objectives. Studies which applied a comprehensive One Health approach, prioritized disparate threats, or conducted cyclical prioritizations for governing bodies were broad in scope, but sparse. The results of our review indicate the need for better guidance on the integration of a One Health approach and the use of various MCDA methods given the main prioritization objectives.
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Affiliation(s)
- Jiawei Zhao
- Risk and Capability Assessment Unit, Public Health Agency of Canada, Ottawa, ON, Canada
| | - Tiffany Smith
- Risk and Capability Assessment Unit, Public Health Agency of Canada, Ottawa, ON, Canada
| | - Melissa Lavigne
- Risk and Capability Assessment Unit, Public Health Agency of Canada, Ottawa, ON, Canada
| | - Cécile Aenishaenslin
- Department of Pathology and Microbiology, University of Montreal, Montreal, QC, Canada
- Centre de recherche en santé publique de L'Université de Montréal et du CIUSSS du Centre-Sud-de-L'Île-de-Montréal, Montréal, QC, Canada
| | - Ruth Cox
- Department of Health Management, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, PE, Canada
- National Wildlife Management Centre, Animal and Plant Health Agency, Woodchester Park, United Kingdom
| | - Aamir Fazil
- National Microbiology Laboratory, Public Health Agency of Canada, Ottawa, ON, Canada
| | - Ana Johnson
- Department of Public Health Sciences, Queen's University, Kingston, ON, Canada
| | - Javier Sanchez
- Department of Health Management, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, PE, Canada
| | - Benoit Hermant
- Risk and Capability Assessment Unit, Public Health Agency of Canada, Ottawa, ON, Canada
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17
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Gruhn S, Witte J, Greiner W, Damm O, Dietzsch M, Kramer R, Knuf M. Epidemiology and economic burden of meningococcal disease in Germany: A systematic review. Vaccine 2022; 40:1932-1947. [DOI: 10.1016/j.vaccine.2022.02.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 12/03/2021] [Accepted: 02/09/2022] [Indexed: 11/26/2022]
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18
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Infektionskrankheiten in Deutschland. Public Health 2022. [DOI: 10.1016/b978-3-437-22262-7.00022-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
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19
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Kheirallah KA, Al-Mistarehi AH, Alsawalha L, Hijazeen Z, Mahrous H, Sheikali S, Al-Ramini S, Maayeh M, Dodeen R, Farajeh M, Masadeh N, Alemam A, Alsulaiman J, Samhouri D. Prioritizing zoonotic diseases utilizing the One Health approach: Jordan's experience. One Health 2021; 13:100262. [PMID: 34027008 PMCID: PMC8121978 DOI: 10.1016/j.onehlt.2021.100262] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 04/28/2021] [Accepted: 04/29/2021] [Indexed: 12/24/2022] Open
Abstract
Background Zoonotic diseases constitute a threat to humans and animals. The Middle East Region is a hotspot for such a threat; given its geographic location under migratory birds' flight paths, mass gatherings, political conflicts, and refugee crises. Thus, prioritizing zoonotic diseases of national significance is critical for preventing and controlling such threats and optimizing limited resources. Using a multi-sectoral One Health (OH) approach, this study aimed at prioritizing zoonotic diseases of national significance to Jordan and identifying future recommendations and action plans. Methods Zoonotic diseases of national significance to Jordan were initially identified (n = 27 diseases). In December 2019, national staff from governmental and non-state sectors were invited to develop ranking criteria, including questions and answers choices, and to weigh each criterion. Then, the national staff were asked to assess zoonotic diseases' priority using the developed criteria and provide recommendations and action plans to strengthen multi-sectoral collaboration. Results Seven zoonotic diseases were identified as being of great significance. Rabies was ranked as the number one priority disease, followed by middle east respiratory syndrome, avian influenza, brucellosis, leishmaniasis, rickettsiosis, and salmonellosis. The highest weighted criteria used to rank diseases were disease severity, outbreaks profile, and potential human-to-human transmission. Establishing a one-health platform, surveillance, laboratory, preparedness planning, outbreak response, and workforce were suggested as recommendations for approaching the priority diseases. Respondents identified data sharing, coordination, event-based surveillance, and effective communication channels as vital areas to enhance prevention and control strategies, conduct joint outbreak investigations, and improve multi-sectoral collaboration. Conclusions This study represents the first attempt to prioritize zoonotic diseases of national significance in Jordan using the OH approach and a semi-qualitative, transparent, and comparative method. Study results can be used as a decision-making guide for policymakers and stakeholders and a cornerstone for combating zoonotic disease threats. This is the first regional report to prioritize zoonotic diseases using the One Health (OH) approach. A list of country relevant zoonotic diseases was identified, prioritized, and approved using the OH Zoonotic Disease Prioritization (OHZDP) tool. Relevant surveillance systems in Jordan should adopt a standardized data sharing mechanism and an event-based method for zoonotic events.
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Affiliation(s)
- Khalid A Kheirallah
- Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | | | - Lora Alsawalha
- Jordan Country Office, World Health Organization, Amman, Jordan
| | - Zaidoun Hijazeen
- Food and Agriculture Organization of the United Nation, Amman, Jordan
| | - Heba Mahrous
- World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | | | | | | | | | | | | | - Amer Alemam
- Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | | | - Dalia Samhouri
- World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt
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20
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New Mononuclear and Binuclear Cu(II), Co(II), Ni(II), and Zn(II) Thiosemicarbazone Complexes with Potential Biological Activity: Antimicrobial and Molecular Docking Study. Molecules 2021; 26:molecules26082288. [PMID: 33920893 PMCID: PMC8071257 DOI: 10.3390/molecules26082288] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 04/07/2021] [Accepted: 04/08/2021] [Indexed: 12/14/2022] Open
Abstract
Herein, we report the synthesis of eight new mononuclear and binuclear Co2+, Ni2+, Cu2+, and Zn2+ methoxy thiosemicarbazone (MTSC) complexes aiming at obtaining thiosemicarbazone complex with potent biological activity. The structure of the MTSC ligand and its metal complexes was fully characterized by elemental analysis, spectroscopic techniques (NMR, FTIR, UV-Vis), molar conductivity, thermogravimetric analysis (TG), and thermal differential analysis (DrTGA). The spectral and analytical data revealed that the obtained thiosemicarbazone-metal complexes have octahedral geometry around the metal center, except for the Zn2+-thiosemicarbazone complexes, which showed a tetrahedral geometry. The antibacterial and antifungal activities of the MTSC ligand and its (Co2+, Ni2+, Cu2+, and Zn2+) metal complexes were also investigated. Interestingly, the antibacterial activity of MTSC- metal complexes against examined bacteria was higher than that of the MTSC alone, which indicates that metal complexation improved the antibacterial activity of the parent ligand. Among different metal complexes, the MTSC- mono- and binuclear Cu2+ complexes showed significant antibacterial activity against Bacillus subtilis and Proteus vulgaris, better than that of the standard gentamycin drug. The in silico molecular docking study has revealed that the MTSC ligand could be a potential inhibitor for the oxidoreductase protein.
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Klamer S, Van Goethem N, Thomas D, Duysburgh E, Braeye T, Quoilin S. Prioritisation for future surveillance, prevention and control of 98 communicable diseases in Belgium: a 2018 multi-criteria decision analysis study. BMC Public Health 2021; 21:192. [PMID: 33482767 PMCID: PMC7820105 DOI: 10.1186/s12889-020-09566-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 09/18/2020] [Indexed: 12/03/2022] Open
Abstract
Background National public health agencies are required to prioritise infectious diseases for prevention and control. We applied the prioritisation method recommended by the European Centre for Disease Prevention and Control to rank infectious diseases, according to their relative importance for surveillance and public health, to inform future public health action in Belgium. Methods We applied the multi-criteria-decision-analysis approach. A working group of epidemiologists and statisticians from Belgium (n = 6) designed a balanced set of prioritisation criteria. A panel of Belgian experts (n = 80) allocated in an online survey each criteria a weight, according to perceived relative importance. Next, experts (n = 37) scored each disease against each criteria in an online survey, guided by disease-specific factsheets referring the period 2010–2016 in Belgium. The weighted sum of the criteria’s scores composed the final weighted score per disease, on which the ranking was based. Sensitivity analyses quantified the impact of eight alternative analysis scenarios on the top-20 ranked diseases. We identified criteria and diseases associated with data-gaps as those with the highest number of blank answers in the scoring survey. Principle components of the final weighted score were identified. Results Working groups selected 98 diseases and 18 criteria, structured in five criteria groups. The diseases ranked highest were (in order) pertussis, human immunodeficiency virus infection, hepatitis C and hepatitis B. Among the five criteria groups, overall the highest weights were assigned to ‘impact on the patient’, followed by ‘impact on public health’, while different perceptions were identified between clinicians, microbiologists and epidemiologists. Among the 18 individual criteria, ‘spreading potential’ and ‘events requiring public health action’ were assigned the highest weights. Principle components clustered with thematic disease groups. Notable data gaps were found among hospital-related diseases. Conclusions We ranked infectious diseases using a standardised reproducible approach. The diseases ranked highest are included in current public health programs, but additional reflection for example about needs among risk groups is recommended. Cross-reference of the obtained ranking with current programs is needed to verify whether resources and activities map priority areas. We recommend to implement this method in a recurrent evaluation cycle of national public health priorities.
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Affiliation(s)
- Sofieke Klamer
- Epidemiology and public health, Epidemiology of infectious diseases, Sciensano, Brussels, Belgium. .,European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.
| | - Nina Van Goethem
- Epidemiology and public health, Epidemiology of infectious diseases, Sciensano, Brussels, Belgium
| | | | | | - Daniel Thomas
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.,Communicable Disease Surveillance Centre, Public Health Wales, Cardiff, Wales
| | - Els Duysburgh
- Epidemiology and public health, Healthcare-associated infections, Sciensano, Brussels, Belgium
| | - Toon Braeye
- Epidemiology and public health, Epidemiology of infectious diseases, Sciensano, Brussels, Belgium
| | - Sophie Quoilin
- Epidemiology and public health, Epidemiology of infectious diseases, Sciensano, Brussels, Belgium
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[How to assess the elimination of viral hepatitis B, C, and D in Germany? Outcomes of an interdisciplinary workshop]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2020; 64:77-90. [PMID: 33326051 PMCID: PMC7772161 DOI: 10.1007/s00103-020-03260-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 11/20/2020] [Indexed: 12/15/2022]
Abstract
Hintergrund Die Weltgesundheitsorganisation (WHO) hat 2016 eine Strategie zur Eliminierung von Hepatitis-B-, -C- und -D-Virusinfektionen verfasst und Indikatoren zum Monitoring des Fortschritts definiert. Das Robert Koch-Institut hat 2019 ein interdisziplinäres Arbeitstreffen zur Verbesserung der Datenlage veranstaltet. Ziele Ziele waren die Vernetzung der Akteure, die Erstellung einer Übersicht zu den in Deutschland vorhandenen Datenquellen zu Hepatitis B, C und D und die Diskussion methodischer Aspekte. Material und Methoden Die für Deutschland relevanten WHO-Indikatoren wurden extrahiert und es wurde bestimmt, wie diese anhand vorliegender Daten konstruiert werden können. Bei dem Arbeitstreffen mit AkteurInnen aus dem öffentlichen Gesundheitsdienst, aus Kliniken, Laboren, von Krankenkassen, Forschungsinstituten, Datenhaltern und Registern wurden in Arbeitsgruppen Erhebungsmethoden diskutiert, welche dazu dienen können, fehlende Daten zu ermitteln. Die Datenquellen und Daten wurden hinsichtlich Qualität, Vollständigkeit sowie praktischer Umsetzbarkeit evaluiert und priorisiert. Ergebnisse Für die Allgemeinbevölkerung können die Indikatoren zu Prävention, Testung, Diagnose, Behandlung, Heilung, Folgeschäden und Mortalität aus Diagnose‑, Versorgungs- und Registerdaten, Daten aus Laboren und klinischen Zentren sowie einzelnen Studien konstruiert werden. Datenquellen für vulnerable Gruppen beschränken sich auf einzelne Studien zu Drogengebrauchenden, Männern, die Sex mit Männern haben, und HIV-Ko-Infizierten. Daten für MigrantInnen, Inhaftierte und SexarbeiterInnen sind kaum verfügbar; ebenso fehlen aktuelle Daten zur Krankheitslast chronischer Hepatitisinfektionen in der Allgemeinbevölkerung. Diskussion Für alle ausgewählten Indikatoren konnten Datenquellen, ihre Besonderheiten und Limitationen identifiziert werden. Im nächsten Schritt gilt es, die entwickelten Ideen in konkrete Projekte mit einzelnen Datenhaltern umzusetzen. Zusatzmaterial online Zusätzliche Informationen sind in der Online-Version dieses Artikels (10.1007/s00103-020-03260-2) enthalten.
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Montibeller G, Franco LA, Carreras A. A Risk Analysis Framework for Prioritizing and Managing Biosecurity Threats. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2020; 40:2462-2477. [PMID: 32579752 PMCID: PMC10645577 DOI: 10.1111/risa.13542] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 05/28/2020] [Accepted: 06/01/2020] [Indexed: 06/11/2023]
Abstract
The increasing need to manage biosecurity threats, such as diseases, zoonoses, and biological weapons, poses serious challenges for risk analysts and policymakers. These threats are large in number, can occur concurrently, and may cause multiple tangible and intangible impacts. They often have an emerging nature, exacerbated by incomplete evidence about their probability of occurrence and potential impacts. There is also a limited amount of time and resources available to evaluate the risks posed by each threat, and it is difficult to learn from past projects. On the other hand, there is also a need to provide policymakers with transparent and consistent threat prioritizations, together with evidence-based recommendations. In response to these challenges, we propose a risk analysis framework for the prioritization and management of biosecurity threats. The framework encompasses key design choices that analysts may use in risk analysis projects along three dimensions: risk support, risk group, and risk organization. The framework has prescriptive value, as a design tool to inform risk analysis projects in this context, along with descriptive value, as a learning tool to understand past projects. We applied the framework prescriptively in two biosecurity threat prioritization projects for the UK Department for Environment, Food and Rural Affairs, and illustrate its descriptive value by reporting our experience of these projects as in-depth case studies. Overall, the proposed framework provides important insights into the impact of different design choices on the success of risk analysis projects for biosecurity threat prioritizations.
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Affiliation(s)
- Gilberto Montibeller
- Management Science and Operations Group, School of Business and EconomicsLoughborough UniversityLoughboroughUK
- Center for Risk and Economic Analysis of Terrorism Events (CREATE)University of Southern CaliforniaLos AngelesCAUSA
| | - L. Alberto Franco
- Management Science and Operations Group, School of Business and EconomicsLoughborough UniversityLoughboroughUK
- Universidad del PacificoLimaPeru
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Ma Y, Tang K, Zhang Y, Zhang C, Cheng L, Zhang F, Zhuang R, Jin B, Zhang Y. Protective CD8 + T-cell response against Hantaan virus infection induced by immunization with designed linear multi-epitope peptides in HLA-A2.1/K b transgenic mice. Virol J 2020; 17:146. [PMID: 33028368 PMCID: PMC7538842 DOI: 10.1186/s12985-020-01421-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 09/28/2020] [Indexed: 12/30/2022] Open
Abstract
Background An effective vaccine that prevents disease caused by hantaviruses is a global public health priority, but up to now, no vaccine has been approved for worldwide use. Therefore, novel vaccines with high prophylaxis efficacy are urgently needed. Methods Herein, we designed and synthesized Hantaan virus (HTNV) linear multi-epitope peptide consisting of HLA-A*02-restricted HTNV cytotoxic T cell (CTL) epitope and pan HLA-DR-binding epitope (PADRE), and evaluated the immunogenicity, as well as effectiveness, of multi-epitope peptides in HLA-A2.1/Kb transgenic mice with interferon (IFN)-γ enzyme-linked immunospot assay, cytotoxic mediator detection, proliferation assay and HTNV-challenge test. Results The results showed that a much higher frequency of specific IFN-γ-secreting CTLs, high levels of granzyme B production, and a strong proliferation capacity of specific CTLs were observed in splenocytes of mice immunized with multi-epitope peptide than in those of a single CTL epitope. Moreover, pre-immunization of multi-epitope peptide could reduce the levels of HTNV RNA loads in the liver, spleen and kidneys of mice, indicating that specific CTL responses induced by multi-epitope peptide could reduce HTNV RNA loads in vivo. Conclusions This study may provide an important foundation for the development of novel peptide vaccines for HTNV prophylaxis.
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Affiliation(s)
- Ying Ma
- Department of Immunology, The Fourth Military Medical University, 169 Changle West Road, Xi'an, 710032, China.
| | - Kang Tang
- Department of Immunology, The Fourth Military Medical University, 169 Changle West Road, Xi'an, 710032, China
| | - Yusi Zhang
- Department of Immunology, The Fourth Military Medical University, 169 Changle West Road, Xi'an, 710032, China
| | - Chunmei Zhang
- Department of Immunology, The Fourth Military Medical University, 169 Changle West Road, Xi'an, 710032, China
| | - Linfeng Cheng
- Department of Microbiology, The Fourth Military Medical University, Xi'an, 710032, China
| | - Fanglin Zhang
- Department of Microbiology, The Fourth Military Medical University, Xi'an, 710032, China
| | - Ran Zhuang
- Department of Immunology, The Fourth Military Medical University, 169 Changle West Road, Xi'an, 710032, China
| | - Boquan Jin
- Department of Immunology, The Fourth Military Medical University, 169 Changle West Road, Xi'an, 710032, China
| | - Yun Zhang
- Department of Immunology, The Fourth Military Medical University, 169 Changle West Road, Xi'an, 710032, China.
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Heudorf U, Gottschalk R. [Mandatory notification of infectious diseases and agents in Germany: development and suggestions for improvement]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2020; 63:777-789. [PMID: 32399605 PMCID: PMC7217598 DOI: 10.1007/s00103-020-03150-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Mit Inkrafttreten des Infektionsschutzgesetzes (IfSG) im Jahr 2001 wurden die Meldepflichten für Infektionskrankheiten und Infektionserreger auf eine neue Basis gestellt. Erstmals wurde zwischen einer Arztmeldepflicht für Infektionskrankheiten und einer Labormeldepflicht für Infektionserreger unterschieden. Ziel war es, durch die Labormeldepflicht Ärzte zu entlasten und dadurch die Meldemoral zu verbessern. Seither ist eine Vielzahl neuer Meldepflichten hinzugekommen. Ziele dieser Arbeit sind es, die Meldepflichten und die Anzahl der gemeldeten Fälle in Deutschland anhand ihrer Entwicklung darzulegen und zu diskutieren – auch vor dem Hintergrund der vorherigen Regelungen in Deutschland (Bundesseuchengesetz) sowie internationaler und europaweiter Empfehlungen (IHR; EU-Kommissions-Beschlüsse 1999, 2018) – und Verbesserungsvorschläge zu unterbreiten. Angesichts der erheblichen Zunahme der Meldepflichten und der Meldungen in den letzten Jahren sowie der Möglichkeiten des IfSG, das neben der Meldepflicht weitere Surveillance-Systeme vorsieht, sollte das Meldewesen auf notwendige Meldepflichten fokussiert werden. Die vorgeschlagene Abschaffung der Meldepflicht für Nachweise von Noroviren und Rotaviren könnte in einem ersten Schritt sowohl die Meldenden als auch die Gesundheitsämter entlasten und so ein effizienteres Meldewesen und eine intensivere und bessere Ermittlungsarbeit der Gesundheitsämter ermöglichen.
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Affiliation(s)
- Ursel Heudorf
- MRE-Netz Rhein-Main, Gesundheitsamt Frankfurt am Main, Frankfurt am Main, Deutschland.
| | - René Gottschalk
- Gesundheitsamt Frankfurt am Main, Frankfurt am Main, Deutschland
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Abstract
Infections with Pseudomonas aeruginosa have been marked with the highest priority for surveillance and epidemiological research on the basis of parameters such as incidence, case fatality rates, chronicity of illness, available options for prevention and treatment, health-care utilization, and societal impact. P. aeruginosa is one of the six ESKAPE pathogens that are the major cause of nosocomial infections and are a global threat because of their capacity to become increasingly resistant to all available antibiotics. This review reports on current pre-clinical and clinical advances of anti-pseudomonal therapies in the fields of drug development, antimicrobial chemotherapy, vaccines, phage therapy, non-bactericidal pathoblockers, outer membrane sensitizers, and host defense reinforcement.
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Affiliation(s)
- Burkhard Tümmler
- Clinical Research Group 'Molecular Pathology of Cystic Fibrosis' and 'Pseudomonas Genomics', Clinic for Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, 30625, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease (BREATH), German Center of Lung Disease, Hannover, 30625, Germany.,Cluster of Excellence RESIST (EXC 2155), Hannover Medical School, Hannover, 30625, Germany
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Paschke A, Schaible UE, Hein W. Legionella transmission through cooling towers: towards better control and research of a neglected pathogen. THE LANCET RESPIRATORY MEDICINE 2019; 7:378-380. [DOI: 10.1016/s2213-2600(19)30041-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 01/21/2019] [Accepted: 01/21/2019] [Indexed: 10/27/2022]
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Abstract
Varicella is a common vaccine-preventable disease that usually presents as a mild disorder but can lead to severe complications. Before the implementation of universal varicella vaccination (UVV) in some European countries, the burden of varicella disease was broadly similar across the region. Despite this, countries adopted heterogeneous varicella vaccination strategies. UVV is currently recommended in 12 European countries. Known barriers to UVV implementation in Europe include (1) a perceived low disease burden and low public health priority; (2) cost-effectiveness and funding availability; (3) concerns related to a shift in varicella disease and incidence of herpes zoster and (4) safety concerns related to measles, mumps, rubella and varicella-associated febrile seizures after the first dose. Countries that implemented UVV experienced decreases in varicella incidence, hospitalizations and complications, showing overall beneficial impact. Alternative strategies targeting susceptible individuals at higher risk of complications have been less effective. This article discusses ways to overcome the barriers to move varicella forward as a truly vaccine preventable disease.
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Mapping the epidemiological distribution and incidence of major zoonotic diseases in South Tigray, North Wollo and Ab'ala (Afar), Ethiopia. PLoS One 2018; 13:e0209974. [PMID: 30596744 PMCID: PMC6312287 DOI: 10.1371/journal.pone.0209974] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 12/14/2018] [Indexed: 10/31/2022] Open
Abstract
Zoonotic diseases continue to affect the health and livelihood of resource limited communities. In Ethiopia, despite the presence of a national master plan for prevention, control and elimination of some common zoonotic diseases, well-organized epidemiological data regarding incidence and distribution are lacking. A retrospective cross-sectional study based on a patient medical data recorded from 2012-2016 in selected districts of Southern Tigray, North Wollo zone of Amhara region and Ab'Ala district of Afar region was conducted to map the distribution and Incidence proportion of major zoonotic diseases. The incidence proportion of four major zoonotic diseases (helminthiasis, tuberculosis (TB), rabies and schistosomiasis) was mapped using qGIS software based on the Health Management Information System (HMIS) data collected from district health facilities. The result indicated that, out of a total 1,273,145 observed human disease cases, 53,614 (4.2%) of them were potential zoonotic diseases that include: helminthiasis (51,192), TB (2,085), rabies (227), schistosomiasis (105) and visceral leishmaniasis (7). The highest incidence proportion of TB (262.8 cases per 100,000 population) and rabies (33.2 cases per 100,000 population) were recorded in Gubalafto and Weldya followed by Raya Alamata (253.4 cases per 100,000 population %), and Ab'Ala and Raya Azebo (29 cases each per 100,000 population) for TB and rabies, respectively. The highest incidence proportion for schistosomiasis was reported in Raya Alamata (50.1 cases per 100,000 population) followed by Gubalafto and Weldya (10.8 cases per 100,000 population). The incidence proportion of visceral leishmaniasis per 100,000 population was 4.1, 1.3 and 1.2 cases for Ab'Ala, Gubalafto and Weldiya, and Raya Azebo districts, respectively. Except rabies, which showed high incidence proportion (p<0.0001) in 5-14 age groups, the other zoonotic diseases showed higher incidence proportion (p<0.0001) in age groups above 15 years. Rabies, helminthiasis and schistosomiasis showed statistically significant variation (p<0.0001) among seasons. Rabies and TB showed decreasing trend within the data recorded years. In animals, only 31 rabies cases and 15 anthrax cases were recorded from 2012 to 2016. This finding highlighted the distribution and incidence of some major zoonotic diseases in the study areas. Systematic and detailed research should be conducted in the future to map the distribution of major zoonotic diseases at regional and country level so as to initiate integrated effort from human and animal health authorities and professionals.
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Jaenisch T, Hendrickx K, Erpicum M, Agulto L, Tomashek KM, Dempsey W, Siqueira JB, Marks MA, Fay MP, Laughlin C, L'Azou M, Leo YS, Narvaez F, Teyssou R, Thomas SJ, Tissera H, Wallace D, Wilder-Smith A, Gubler DJ, Cassetti MC. Development of standard clinical endpoints for use in dengue interventional trials: introduction and methodology. BMC Med Res Methodol 2018; 18:134. [PMID: 30442099 PMCID: PMC6238344 DOI: 10.1186/s12874-018-0601-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 11/01/2018] [Indexed: 11/10/2022] Open
Abstract
Background As increasing numbers of dengue vaccines and therapeutics are in clinical development, standardized consensus clinical endpoint definitions are urgently needed to assess the efficacy of different interventions with respect to disease severity. We aimed to convene dengue experts representing various sectors and dengue endemic areas to review the literature and propose clinical endpoint definitions for moderate and severe disease based on the framework provided by the WHO 2009 classification. Methods The endpoints were first proposed and discussed in a structured expert consultation. After that, the Delphi method was carried out to assess the usefulness, validity and feasibility of the standardized clinical disease endpoints for interventional dengue research. Results Most respondents (> 80%) agreed there is a need for both standardized clinical endpoints and operationalization of severe endpoints. Most respondents (67%) felt there is utility for moderate severity endpoints, but cited challenges in their development. Hospitalization as a moderate endpoint of disease severity or measure of public health impact was deemed to be useful by only 47% of respondents, but 89% felt it could bring about supplemental information if carefully contextualized according to data collection setting. Over half of the respondents favored alignment of the standard endpoints with the WHO guidelines (58%), but cautioned that the endpoints could have ramifications for public health practice. In terms of data granularity of the endpoints, there was a slight preference for a categorical vs numeric system (e.g. 1–10) (47% vs 34%), and 74% of respondents suggested validating the endpoints using large prospective data sets. Conclusion The structured consensus-building process was successful taking into account the history of the debate around potential endpoints for severe dengue. There is clear support for the development of standardized endpoints for interventional clinical research and the need for subsequent validation with prospective data sets. Challenges include the complexity of developing moderate disease research endpoints for dengue.
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Affiliation(s)
- Thomas Jaenisch
- Section Clinical Tropical Medicine, Department of Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany
| | - Kim Hendrickx
- Postdoctoral Fellow of the Research Foundation - Flanders (FWO) and Research Associate of Spiral, Université de Liège, Liège, Belgium.,Mesydel, SPIRAL Research Center, Département de Science Politique, Université de Liège, Liège, Belgium
| | - Martin Erpicum
- Mesydel, SPIRAL Research Center, Département de Science Politique, Université de Liège, Liège, Belgium
| | - Liane Agulto
- Division of Microbiology and Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD, USA
| | - Kay M Tomashek
- Division of Microbiology and Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD, USA
| | - Walla Dempsey
- Division of Microbiology and Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD, USA
| | | | - Morgan A Marks
- Pharmacoepidemiology Department, Merck & Co., Inc., Kenilworth, New Jersey, USA
| | - Michael P Fay
- Biostatistics Research Branch, Division of Clinical Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD, USA
| | - Catherine Laughlin
- Division of Microbiology and Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD, USA
| | - Maina L'Azou
- Global Epidemiology, Sanofi-Pasteur, Lyon, France
| | - Yee-Sin Leo
- Institute of Infectious Disease and Epidemiology, Tan Tock Seng Hospital, and National Centre for Infectious Diseases MOH, Singapore, Singapore
| | - Federico Narvaez
- Infectious Diseases Unit, National Pediatric Reference Hospital, Hospital Infantil Manuel de Jesús Rivera, Managua, Nicaragua
| | - Remy Teyssou
- Partnership for Dengue Control, Fondation Merieux, Lyon, France.,Unité de Virologie, Institut de Recherche Biomédicale des Armées, Brétigny-rur-Orge, France
| | - Stephen J Thomas
- Division of Infectious Diseases, State University of New York, Upstate Medical University, Syracuse, NY, USA
| | - Hasitha Tissera
- National Dengue Control Unit, Ministry of Health, Colombo, Sri Lanka
| | - Derek Wallace
- Takeda Pharmaceuticals International AG, Zurich, Switzerland
| | - Annelies Wilder-Smith
- Partnership for Dengue Control, Fondation Merieux, Lyon, France.,Lee Kong Chian School of Medicine, Nayang Technological University, Singapore, Singapore
| | - Duane J Gubler
- Partnership for Dengue Control, Fondation Merieux, Lyon, France.,Emerging Infectious Diseases Programme, Duke-NUS Medical School, Singapore, Singapore
| | - M Cristina Cassetti
- Division of Microbiology and Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD, USA.
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Agudelo-Suárez AN, Villamil-Jiménez LC. [Public policies of zoonoses in Colombia, 1975-2014. An approach from Political Science and Public Health]. Rev Salud Publica (Bogota) 2018; 19:787-794. [PMID: 30183832 DOI: 10.15446/rsap.v19n6.72109] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 07/21/2017] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE To analyze public policies regarding zoonoses in Colombia, in terms of responsiveness, decision-making, processes and results, approaching their impact in the period between 1975 and 2014. METHODS An analysis and assessment of public policies were carried out using a mixed design. Some zoonoses were selected based on their importance for public health, epidemiology, policy and availability of consecutive information. Secondary documentary sources and primary sources were used through an annotated survey. An interpretive, historical and structural framework was built from an economic, epidemiological and political point of view. For policy analysis, the sequential approach was used and, in a complementary manner, the institutional development approach. A trend analysis of selected zoonoses was carried out. RESULTS The interpretive framework addressed the macro context and the key processes in two periods: 1975-1990 and 1990-2014. The analysis of public policies in zoonoses was conducted according to their decision level and the vertical and horizontal relationships between them. A trend analysis of zoonoses in the long term, as well as an assessment of the impact of the policies, was obtained. CONCLUSIONS Policy diversification and instrumental depth suggest that they have approached the understanding and management capacity of the complex problems of zoonoses. However, the trend analysis suggests that the impact of public policies on zoonoses is still limited.
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Affiliation(s)
| | - Luis C Villamil-Jiménez
- LV: MV. Ph. D. Veterinary Epidemiology and Economics. M. Sc. Medicina Veterinaria Preventiva. Universidad de la Salle. Bogotá, Colombia.
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Mehand MS, Millett P, Al-Shorbaji F, Roth C, Kieny MP, Murgue B. World Health Organization Methodology to Prioritize Emerging Infectious Diseases in Need of Research and Development. Emerg Infect Dis 2018; 24:e171427. [PMID: 30124424 PMCID: PMC6106429 DOI: 10.3201/eid2409.171427] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
The World Health Organization R&D Blueprint aims to accelerate the availability of medical technologies during epidemics by focusing on a list of prioritized emerging diseases for which medical countermeasures are insufficient or nonexistent. The prioritization process has 3 components: a Delphi process to narrow down a list of potential priority diseases, a multicriteria decision analysis to rank the short list of diseases, and a final Delphi round to arrive at a final list of 10 diseases. A group of international experts applied this process in January 2017, resulting in a list of 10 priority diseases. The robustness of the list was tested by performing a sensitivity analysis. The new process corrected major shortcomings in the pre-R&D Blueprint approach to disease prioritization and increased confidence in the results.
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Seugendo M, Janssen I, Lang V, Hasibuan I, Bohne W, Cooper P, Daniel R, Gunka K, Kusumawati RL, Mshana SE, von Müller L, Okamo B, Ortlepp JR, Overmann J, Riedel T, Rupnik M, Zimmermann O, Groß U. Prevalence and Strain Characterization of Clostridioides (Clostridium) difficile in Representative Regions of Germany, Ghana, Tanzania and Indonesia - A Comparative Multi-Center Cross-Sectional Study. Front Microbiol 2018; 9:1843. [PMID: 30131799 PMCID: PMC6090210 DOI: 10.3389/fmicb.2018.01843] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 07/24/2018] [Indexed: 12/20/2022] Open
Abstract
Clostridioides (Clostridium) difficile infections (CDI) are considered worldwide as emerging health threat. Uptake of C. difficile spores may result in asymptomatic carrier status or lead to CDI that could range from mild diarrhea, eventually developing into pseudomembranous colitis up to a toxic megacolon that often results in high mortality. Most epidemiological studies to date have been performed in middle- and high income countries. Beside others, the use of antibiotics and the composition of the microbiome have been identified as major risk factors for the development of CDI. We therefore postulate that prevalence rates of CDI and the distribution of C. difficile strains differ between geographical regions depending on the regional use of antibiotics and food habits. A total of 593 healthy control individuals and 608 patients suffering from diarrhea in communities in Germany, Ghana, Tanzania and Indonesia were selected for a comparative multi-center cross-sectional study. The study populations were screened for the presence of C. difficile in stool samples. Cultured C. difficile strains (n = 84) were further subtyped and characterized using PCR-ribotyping, determination of toxin production, and antibiotic susceptibility testing. Prevalence rates of C. difficile varied widely between the countries. Whereas high prevalence rates were observed in symptomatic patients living in Germany and Indonesia (24.0 and 14.7%), patients from Ghana and Tanzania showed low detection rates (4.5 and 6.4%). Differences were also obvious for ribotype distribution and toxin repertoires. Toxin A+/B+ ribotypes 001/072 and 078 predominated in Germany, whereas most strains isolated from Indonesian patients belonged to toxin A+/B+ ribotype SLO160 and toxin A-/B+ ribotype 017. With 42.9–73.3%, non-toxigenic strains were most abundant in Africa, but were also found in Indonesia at a rate of 18.2%. All isolates were susceptible to vancomycin and metronidazole. Mirroring the antibiotic use, however, moxifloxacin resistance was absent in African C. difficile isolates but present in Indonesian (24.2%) and German ones (65.5%). This study showed that CDI is a global health threat with geographically different prevalence rates which might reflect distinct use of antibiotics. Significant differences for distributions of ribotypes, toxin production, and antibiotic susceptibilities were observed.
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Affiliation(s)
- Mwanaisha Seugendo
- Department of Pediatrics and Child Health, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Iryna Janssen
- Institute of Medical Microbiology, University Medical Center Göttingen Göttingen, Germany
| | - Vanessa Lang
- Institute of Medical Microbiology, University Medical Center Göttingen Göttingen, Germany
| | - Irene Hasibuan
- Institute of Medical Microbiology, University Medical Center Göttingen Göttingen, Germany
| | - Wolfgang Bohne
- Institute of Medical Microbiology, University Medical Center Göttingen Göttingen, Germany
| | | | - Rolf Daniel
- Department of Genomic and Applied Microbiology, University of Göttingen, Göttingen, Germany
| | - Katrin Gunka
- Institute of Medical Microbiology, University Medical Center Göttingen Göttingen, Germany
| | - R L Kusumawati
- Department of Microbiology, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Stephen E Mshana
- Department of Medical Microbiology, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Lutz von Müller
- Institute of Medical Microbiology, Saarland University, Homburg, Germany
| | - Benard Okamo
- Department of Medical Microbiology, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | | | - Jörg Overmann
- Department Microbial Ecology and Diversity Research, Leibniz Institute DSMZ, Braunschweig, Germany
| | - Thomas Riedel
- Department Microbial Ecology and Diversity Research, Leibniz Institute DSMZ, Braunschweig, Germany
| | - Maja Rupnik
- Institute of Public Health Maribor, Maribor, Slovenia.,Faculty of Medicine, University of Maribor, Maribor, Slovenia
| | - Ortrud Zimmermann
- Institute of Medical Microbiology, University Medical Center Göttingen Göttingen, Germany
| | - Uwe Groß
- Institute of Medical Microbiology, University Medical Center Göttingen Göttingen, Germany
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Neevel AMG, Hemrika T, Claassen E, van de Burgwal LHM. A research agenda to reinforce rabies control: A qualitative and quantitative prioritization. PLoS Negl Trop Dis 2018; 12:e0006387. [PMID: 29727444 PMCID: PMC5955568 DOI: 10.1371/journal.pntd.0006387] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 05/16/2018] [Accepted: 03/14/2018] [Indexed: 12/24/2022] Open
Abstract
Background Despite the existence of safe and effective vaccines, rabies disease still causes an estimated 59,000 human deaths a year in the endemic areas in Asia and Africa. These numbers reflect severe drawbacks regarding the implementation of PrEP and PEP in endemic settings, such as lack of political will and low priority given to rabies. Since these contextual factors have proven to be persistent, there is an urgency to improve current strategies or develop novel approaches in order to control rabies disease in the future. Methods/Findings This study aimed to identify and systematically prioritize the research needs, through interviews and questionnaires with key-opinion-leaders (KOLs). A total of 46 research needs were identified and prioritized. The top research needs are considered very high priority based on both importance for rabies control and need for improvement. KOLs agree that animal rabies control remains most important for rabies control, while research on human host, agent (rabies virus) and the environment should be prioritized in terms of need for improvement. A wide variety in perceptions is observed between and within the disciplines of virology, public health and veterinary health and between KOLs with more versus those with less experience in the field. Conclusion/Significance The results of this study give well-defined, prioritized issues that stress the drawbacks that are experienced by KOLs in daily practice. The most important research domains are: 1) cheap and scalable production system for RIG 2) efficacy of dog mass vaccination programs and 3) cheap human vaccines. Addressing these research needs should exist next to and may reinforce current awareness and mass vaccination campaigns. The differences in perspectives between actors revealed in this study are informative for effective execution of the One Health research agenda. Rabies is a 100% vaccine-preventable disease but invariably fatal once symptoms occur. Annually, tens of thousands of people die after being infected with rabies virus, predominantly through bites or scratches of infected dogs. The stable mortality rates highlight the limitations of current disease specific interventions, including prophylaxes, awareness campaigns and mass vaccination of dogs. Consequently, research is needed to develop improved and novel strategies that circumvent the barriers faced in implementation in endemic settings. Interest for rabies, however, is limited and to effectively allocate budgets the field would benefit from a more focused research agenda. This study prioritized research topics based on the importance for rabies control and the need for improvement. According to experts, research should focus on 1) cheap and scalable production systems for RIG; 2) efficacy of dog mass vaccination programs and; 3) development of a cheap human vaccine. By elucidating differences in perceptions of stakeholders between disciplines and between those with more versus those with less experience in the field, this study also provides practical insights to inform stakeholders concerned with the implementation of interdisciplinary collaboration in the field of rabies. The prioritization of rabies-specific research needs is a vital step in accelerating innovation necessary to decrease the burden of disease.
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Affiliation(s)
- Anne M. G. Neevel
- Athena Institute, VU University, Amsterdam, the Netherlands
- Viroclinics Biosciences, Rotterdam, the Netherlands
- * E-mail:
| | - Tessa Hemrika
- Athena Institute, VU University, Amsterdam, the Netherlands
| | - Eric Claassen
- Athena Institute, VU University, Amsterdam, the Netherlands
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Horigan V, De Nardi M, Simons RRL, Bertolini S, Crescio MI, Estrada-Peña A, Léger A, Maurella C, Ru G, Schuppers M, Stärk KDC, Adkin A. Using multi-criteria risk ranking methodology to select case studies for a generic risk assessment framework for exotic disease incursion and spread through Europe. Prev Vet Med 2018; 153:47-55. [PMID: 29653734 DOI: 10.1016/j.prevetmed.2018.02.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 01/26/2018] [Accepted: 02/25/2018] [Indexed: 10/17/2022]
Abstract
We present a novel approach of using the multi-criteria pathogen prioritisation methodology as a basis for selecting the most appropriate case studies for a generic risk assessment framework. The approach uses selective criteria to rank exotic animal health pathogens according to the likelihood of introduction and the impact of an outbreak if it occurred in the European Union (EU). Pathogens were evaluated based on their impact on production at the EU level and international trade. A subsequent analysis included criteria of relevance to quantitative risk assessment case study selection, such as the availability of data for parameterisation, the need for further research and the desire for the case studies to cover different routes of transmission. The framework demonstrated is flexible with the ability to adjust both the criteria and their weightings to the user's requirements. A web based tool has been developed using the RStudio shiny apps software, to facilitate this.
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Affiliation(s)
- V Horigan
- Department of Epidemiological Sciences, Animal and Plant Health Agency, Woodham Lane, New Haw, Surrey, KT15 3NB, UK.
| | - M De Nardi
- SAFOSO AG, Waldeggstrasse 1, CH3097 Liebefeld, Switzerland
| | - R R L Simons
- Department of Epidemiological Sciences, Animal and Plant Health Agency, Woodham Lane, New Haw, Surrey, KT15 3NB, UK
| | - S Bertolini
- Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d'Aosta (IZSPLVA), Italy
| | - M I Crescio
- Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d'Aosta (IZSPLVA), Italy
| | - A Estrada-Peña
- University of Zaragoza (UNIZAR), Calle de Pedro Cerbuna 12, 50009 Zaragoza, Spain
| | - A Léger
- SAFOSO AG, Waldeggstrasse 1, CH3097 Liebefeld, Switzerland
| | - C Maurella
- Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d'Aosta (IZSPLVA), Italy
| | - G Ru
- Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d'Aosta (IZSPLVA), Italy
| | - M Schuppers
- SAFOSO AG, Waldeggstrasse 1, CH3097 Liebefeld, Switzerland
| | - K D C Stärk
- SAFOSO AG, Waldeggstrasse 1, CH3097 Liebefeld, Switzerland
| | - A Adkin
- Department of Epidemiological Sciences, Animal and Plant Health Agency, Woodham Lane, New Haw, Surrey, KT15 3NB, UK
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Groß U, Brzuszkiewicz E, Gunka K, Starke J, Riedel T, Bunk B, Spröer C, Wetzel D, Poehlein A, Chibani C, Bohne W, Overmann J, Zimmermann O, Daniel R, Liesegang H. Comparative genome and phenotypic analysis of three Clostridioides difficile strains isolated from a single patient provide insight into multiple infection of C. difficile. BMC Genomics 2018; 19:1. [PMID: 29291715 PMCID: PMC5749029 DOI: 10.1186/s12864-017-4368-0] [Citation(s) in RCA: 164] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 12/06/2017] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Clostridioides difficile infections (CDI) have emerged over the past decade causing symptoms that
range from mild, antibiotic-associated diarrhea (AAD) to life-threatening toxic megacolon. In this study, we describe a multiple and isochronal (mixed) CDI caused by the isolates DSM 27638, DSM 27639 and DSM 27640 that already initially showed different morphotypes on solid media. RESULTS The three isolates belonging to the ribotypes (RT) 012 (DSM 27639) and 027 (DSM 27638 and DSM 27640)
were phenotypically characterized and high quality closed genome sequences were generated. The genomes were compared with seven reference strains including three strains of the RT 027, two of the RT 017, and one of the RT 078 as well as a multi-resistant RT 012 strain. The analysis of horizontal gene transfer events revealed gene acquisition incidents that sort the strains within the time line of the spread of their RTs within Germany. We could show as well that horizontal gene transfer between the members of different RTs occurred within this multiple infection. In addition, acquisition and exchange of virulence-related features including antibiotic resistance genes were observed. Analysis of the two genomes assigned to RT 027 revealed three single nucleotide polymorphisms (SNPs) and apparently a regional genome modification within the flagellar switch that regulates the fli operon. CONCLUSION Our findings show that (i) evolutionary events based on horizontal gene transfer occur within an ongoing
CDI and contribute to the adaptation of the species by the introduction of new genes into the genomes, (ii) within a multiple infection of a single patient the exchange of genetic material was responsible for a much higher genome variation than the observed SNPs.
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Affiliation(s)
- Uwe Groß
- Institute for Medical Microbiology, University Medical Center Göttingen, Göttingen, Germany
| | - Elzbieta Brzuszkiewicz
- Department of Genomic and Applied Microbiology & Göttingen Genomics Laboratory, Institute of Microbiology and Genetics, Georg-August-University, Göttingen, Germany
| | - Katrin Gunka
- Institute for Medical Microbiology, University Medical Center Göttingen, Göttingen, Germany
| | - Jessica Starke
- Department of Genomic and Applied Microbiology & Göttingen Genomics Laboratory, Institute of Microbiology and Genetics, Georg-August-University, Göttingen, Germany
| | - Thomas Riedel
- Leibniz Institute DSMZ-German Collection of Microorganisms and Cell Cultures, Braunschweig, Germany.,German Center for Infection Research (DZIF), Partner Site Hannover-Braunschweig, Braunschweig, Germany
| | - Boyke Bunk
- Leibniz Institute DSMZ-German Collection of Microorganisms and Cell Cultures, Braunschweig, Germany
| | - Cathrin Spröer
- Leibniz Institute DSMZ-German Collection of Microorganisms and Cell Cultures, Braunschweig, Germany
| | - Daniela Wetzel
- Institute for Medical Microbiology, University Medical Center Göttingen, Göttingen, Germany
| | - Anja Poehlein
- Department of Genomic and Applied Microbiology & Göttingen Genomics Laboratory, Institute of Microbiology and Genetics, Georg-August-University, Göttingen, Germany
| | - Cynthia Chibani
- Department of Genomic and Applied Microbiology & Göttingen Genomics Laboratory, Institute of Microbiology and Genetics, Georg-August-University, Göttingen, Germany
| | - Wolfgang Bohne
- Institute for Medical Microbiology, University Medical Center Göttingen, Göttingen, Germany
| | - Jörg Overmann
- Leibniz Institute DSMZ-German Collection of Microorganisms and Cell Cultures, Braunschweig, Germany.,German Center for Infection Research (DZIF), Partner Site Hannover-Braunschweig, Braunschweig, Germany
| | - Ortrud Zimmermann
- Institute for Medical Microbiology, University Medical Center Göttingen, Göttingen, Germany
| | - Rolf Daniel
- Department of Genomic and Applied Microbiology & Göttingen Genomics Laboratory, Institute of Microbiology and Genetics, Georg-August-University, Göttingen, Germany
| | - Heiko Liesegang
- Department of Genomic and Applied Microbiology & Göttingen Genomics Laboratory, Institute of Microbiology and Genetics, Georg-August-University, Göttingen, Germany.
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Hongoh V, Gosselin P, Michel P, Ravel A, Waaub JP, Campagna C, Samoura K. Criteria for the prioritization of public health interventions for climate-sensitive vector-borne diseases in Quebec. PLoS One 2017; 12:e0190049. [PMID: 29281726 PMCID: PMC5744945 DOI: 10.1371/journal.pone.0190049] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2017] [Accepted: 12/07/2017] [Indexed: 12/03/2022] Open
Abstract
Prioritizing resources for optimal responses to an ever growing list of existing and emerging infectious diseases represents an important challenge to public health. In the context of climate change, there is increasing anticipated variability in the occurrence of infectious diseases, notably climate-sensitive vector-borne diseases. An essential step in prioritizing efforts is to identify what considerations and concerns to take into account to guide decisions and thus set disease priorities. This study was designed to perform a comprehensive review of criteria for vector-borne disease prioritization, assess their applicability in a context of climate change with a diverse cross-section of stakeholders in order to produce a baseline list of considerations to use in this decision-making context. Differences in stakeholder choices were examined with regards to prioritization of these criteria for research, surveillance and disease prevention and control objectives. A preliminary list of criteria was identified following a review of the literature. Discussions with stakeholders were held to consolidate and validate this list of criteria and examine their effects on disease prioritization. After this validation phase, a total of 21 criteria were retained. A pilot vector-borne disease prioritization exercise was conducted using PROMETHEE to examine the effects of the retained criteria on prioritization in different intervention domains. Overall, concerns expressed by stakeholders for prioritization were well aligned with categories of criteria identified in previous prioritization studies. Weighting by category was consistent between stakeholders overall, though some significant differences were found between public health and non-public health stakeholders. From this exercise, a general model for climate-sensitive vector-borne disease prioritization has been developed that can be used as a starting point for further public health prioritization exercises relating to research, surveillance, and prevention and control interventions in a context of climate change. Multi-stakeholder engagement in prioritization can help broaden the range of criteria taken into account, offer opportunities for early identification of potential challenges and may facilitate acceptability of any resulting decisions.
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Affiliation(s)
- Valerie Hongoh
- The Research Group on Epidemiology of Zoonoses and Public Health (GREZOSP), Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, Canada
- Department of Pathology and Microbiology, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, Canada
| | - Pierre Gosselin
- Institut national de santé publique Québec (INSPQ), Québec, Canada
- Ouranos, Consortium on Regional Climatology and Adaptation to Climate Change, Montreal, Canada
| | - Pascal Michel
- The Research Group on Epidemiology of Zoonoses and Public Health (GREZOSP), Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, Canada
- National Microbiology Laboratory at Saint-Hyacinthe, Public Health Agency of Canada, Saint-Hyacinthe, Canada
| | - André Ravel
- The Research Group on Epidemiology of Zoonoses and Public Health (GREZOSP), Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, Canada
- Department of Pathology and Microbiology, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, Canada
| | - Jean-Philippe Waaub
- Group for Research in Decision Analysis (GERAD, HEC Montréal, Polytechnique Montréal, McGill, UQAM), Montreal, Canada
| | - Céline Campagna
- Institut national de santé publique Québec (INSPQ), Québec, Canada
- Department of Social and Preventive Medicine, Université Laval, Québec, Canada
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Scott J, Wilson N, Baker MG. Improving New Zealand's preparations for the next pandemic. Aust N Z J Public Health 2017; 42:3-6. [PMID: 29168306 PMCID: PMC7159781 DOI: 10.1111/1753-6405.12736] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Affiliation(s)
- Julia Scott
- Department of Public Health, University of Otago, New Zealand
| | - Nick Wilson
- Department of Public Health, University of Otago, New Zealand
| | - Michael G Baker
- Department of Public Health, University of Otago, New Zealand
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Witjas-Paalberends ER, van Laarhoven LPM, van de Burgwal LHM, Feilzer J, de Swart J, Claassen E, Jansen WTM. Challenges and best practices for big data-driven healthcare innovations conducted by profit–non-profit partnerships – a quantitative prioritization. INTERNATIONAL JOURNAL OF HEALTHCARE MANAGEMENT 2017. [DOI: 10.1080/20479700.2017.1371367] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- E. R. Witjas-Paalberends
- Department of Operations: Innovation & Development, PwC Advisory Consulting, Amsterdam, The Netherlands
| | - L. P. M. van Laarhoven
- Faculty of Earth and Life Sciences, Athena Institute, VU University, Amsterdam, The Netherlands
| | - L. H. M. van de Burgwal
- Faculty of Earth and Life Sciences, Athena Institute, VU University, Amsterdam, The Netherlands
| | - J. Feilzer
- Department of Data Analytics, PwC Advisory Consulting, Amsterdam, The Netherlands
| | - J. de Swart
- Department of Data Analytics, PwC Advisory Consulting, Amsterdam, The Netherlands
- Nyenrode Business University, Breukelen, The Netherlands
| | - E. Claassen
- Faculty of Earth and Life Sciences, Athena Institute, VU University, Amsterdam, The Netherlands
| | - W. T. M. Jansen
- Department of Operations: Innovation & Development, PwC Advisory Consulting, Amsterdam, The Netherlands
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Devleesschauwer B, Bouwknegt M, Dorny P, Gabriël S, Havelaar AH, Quoilin S, Robertson LJ, Speybroeck N, Torgerson PR, van der Giessen JW, Trevisan C. Risk ranking of foodborne parasites: State of the art. Food Waterborne Parasitol 2017; 8-9:1-13. [PMID: 32095638 PMCID: PMC7034010 DOI: 10.1016/j.fawpar.2017.11.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 11/17/2017] [Accepted: 11/22/2017] [Indexed: 12/19/2022] Open
Abstract
In a time of increasing threats and decreasing financial resources, monitoring and controlling all possible foodborne hazards at the same time and to the same extent has become more challenging than ever. Therefore, attention is increasingly being paid to the so-called "risk ranking" methods that enable decision makers to focus on the most important foodborne hazards - even when time is limited and knowledge incomplete. In this review paper, we provide an overview of the most common quantitative methods and metrics used for ranking the risks associated with foodborne parasites and present the state of the art on risk ranking exercises for foodborne parasites. A number of risk ranking metrics and methods are available, ranging from simple approaches that can be used to assess the health or economic impact of a foodborne parasitic disease, to more complicated but more comprehensive multi-criteria assessments. For health impact assessment, measures of population health such as disease occurrence and number of deaths; Disability-Adjusted Life Years (DALYs) measuring the healthy life years lost; and Quality-Adjusted Life Years (QALYs) measuring the number of life years lived in optimal health, are described. For economic impact assessment, applied approaches that measure the cost-of-illness from a societal perspective and stated preference methods are outlined. Finally, Multi-Criteria Decision Analysis (MCDA), which can be used to integrate multiple metrics and criteria into a single ranking, is described. These risk ranking methods for foodborne parasites are increasingly performed to aid priority setting at global, regional, and national levels. As different stakeholders have their own prioritization objectives and beliefs, the outcome of such exercises is necessarily context-dependent. Therefore, when designing a risk ranking exercise for foodborne parasites, it is important to choose the metrics and methods, as well as what to rank, in the light of the predefined context of the question being addressed and the target audience.
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Key Words
- Cost-of-illness
- DALY, Disability-Adjusted Life Year
- Disability-adjusted life years
- FAO, Food and Agriculture Organization of the United Nations
- Foodborne parasites
- GBD, Global Burden of Disease
- MCDA, Multi-Criteria Decision Analysis
- Multi-criteria decision analysis
- Priority setting
- QALY, Quality-Adjusted Life Year
- SMPH, Summary Measure of Population Health
- WHO, World Health Organization
- WTA, Willingness-to-accept
- WTP, Willingness-to-pay
- YLD, Year Lived with Disability
- YLL, Year of Life Lost
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Affiliation(s)
- Brecht Devleesschauwer
- Department of Public Health and Surveillance, Scientific Institute of Public Health (WIV-ISP), Brussels, Belgium
| | | | - Pierre Dorny
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Laboratory of Parasitology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Sarah Gabriël
- Department of Veterinary Public Health and Food Safety, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Arie H. Havelaar
- Emerging Pathogens Institute, Institute for Sustainable Food Systems, Animal Sciences Department, University of Florida, Gainesville, FL, USA
| | - Sophie Quoilin
- Department of Public Health and Surveillance, Scientific Institute of Public Health (WIV-ISP), Brussels, Belgium
| | - Lucy J. Robertson
- Parasitology, Department of Food Safety and Infection Biology, Faculty of Veterinary Medicine, Norwegian University of Life Sciences, Adamstuen Campus, Oslo, Norway
| | - Niko Speybroeck
- Institute of Health and Society (IRSS), Université Catholique de Louvain, Brussels, Belgium
| | - Paul R. Torgerson
- Section of Epidemiology, Vetsuisse Faculty, University of Zürich, Switzerland
| | - Joke W.B. van der Giessen
- Centre for Zoonoses and Environmental Microbiology, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Chiara Trevisan
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
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41
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Neslo REJ, Oei W, Janssen MP. Insight into "Calculated Risk": An Application to the Prioritization of Emerging Infectious Diseases for Blood Transfusion Safety. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2017; 37:1783-1795. [PMID: 28229466 DOI: 10.1111/risa.12752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 09/05/2016] [Accepted: 09/15/2016] [Indexed: 06/06/2023]
Abstract
Increasing identification of transmissions of emerging infectious diseases (EIDs) by blood transfusion raised the question which of these EIDs poses the highest risk to blood safety. For a number of the EIDs that are perceived to be a threat to blood safety, evidence on actual disease or transmission characteristics is lacking, which might render measures against such EIDs disputable. On the other hand, the fact that we call them "emerging" implies almost by definition that we are uncertain about at least some of their characteristics. So what is the relative importance of various disease and transmission characteristics, and how are these influenced by the degree of uncertainty associated with their actual values? We identified the likelihood of transmission by blood transfusion, the presence of an asymptomatic phase of infection, prevalence of infection, and the disease impact as the main characteristics of the perceived risk of disease transmission by blood transfusion. A group of experts in the field of infectious diseases and blood transfusion ranked sets of (hypothetical) diseases with varying degrees of uncertainty associated with their disease characteristics, and used probabilistic inversion to obtain probability distributions for the weight of each of these risk characteristics. These distribution weights can be used to rank both existing and newly emerging infectious diseases with (partially) known characteristics. Analyses show that in case there is a lack of data concerning disease characteristics, it is the uncertainty concerning the asymptomatic phase and the disease impact that are the most important drivers of the perceived risk. On the other hand, if disease characteristics are well established, it is the prevalence of infection and the transmissibility of the disease by blood transfusion that will drive the perceived risk. The risk prioritization model derived provides an easy to obtain and rational expert assessment of the relative importance of an (emerging) infectious disease, requiring only a limited amount of information. Such a model might be used to justify a rational and proportional response to an emerging infectious disease, especially in situations where little or no specific information is available.
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Affiliation(s)
- R E J Neslo
- Julius Centre for Health Sciences and Primary Health Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - W Oei
- Julius Centre for Health Sciences and Primary Health Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - M P Janssen
- Julius Centre for Health Sciences and Primary Health Care, University Medical Center Utrecht, Utrecht, The Netherlands
- TTA department, Sanquin Research, Amsterdam, The Netherlands
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42
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Diard M, Hardt WD. Evolution of bacterial virulence. FEMS Microbiol Rev 2017; 41:679-697. [DOI: 10.1093/femsre/fux023] [Citation(s) in RCA: 89] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 04/24/2017] [Indexed: 12/13/2022] Open
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Dudareva-Vizule S, Haar K, Sailer A, Jansen K, Hamouda O, Wisplinghoff H, Tiemann C, Pape E, Bremer V. Establishment of a voluntary electronic Chlamydia trachomatis laboratory surveillance system in Germany, 2008 to 2014. ACTA ACUST UNITED AC 2017; 22:30459. [PMID: 28205505 PMCID: PMC5316906 DOI: 10.2807/1560-7917.es.2017.22.6.30459] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Accepted: 09/08/2016] [Indexed: 11/20/2022]
Abstract
Chlamydia trachomatis (CT) infections are not reportable in Germany and limited data on prevalence are available. CT screening has been offered free of charge to pregnant women since 1995 and to all women under 25 years since 2008. For symptomatic women and men, diagnostic testing is covered by statutory health insurance. We describe the establishment of a nationwide, laboratory-based, voluntary sentinel that electronically collects information on all performed CT tests with test results, test reason and patient information. The sentinel represents one third of all performed CT tests in Germany. In the period from 2008 to 2014, 3,877,588 CT tests were reported, 93% in women. Women aged 20–24 years and men aged 25–29 years were the most frequently tested age groups. The overall proportion of positive tests (PPT) among women was 3.9% and among men 11.0%. The highest PPT among women was in the age groups 15–19 (6.8%) and 20–24 years (5.9%), and among men in the age groups 20–24 (19.2%), 15–19 (15.4%) and 25–29 years (14.8%). The PPT for CT was high among women and men younger than 25 years. Prevention is urgently needed. Monitoring of CT infection in Germany should be continued.
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Affiliation(s)
- Sandra Dudareva-Vizule
- Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany.,Charité University Medicine, Berlin, Germany
| | - Karin Haar
- Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Andrea Sailer
- Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Klaus Jansen
- Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Osamah Hamouda
- Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Hilmar Wisplinghoff
- Wisplinghoff Laboratories, Cologne, Germany.,Institute for Medical Microbiology, University of Cologne, Cologne, Germany.,Institute for Microbiology, University Witten/Herdecke, Witten, Germany
| | | | - Eberhard Pape
- Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Viviane Bremer
- Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
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- The Chlamydia trachomatis laboratory sentinel team is listed at the end of the article
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A Short-Snouted, Middle Triassic Phytosaur and its Implications for the Morphological Evolution and Biogeography of Phytosauria. Sci Rep 2017; 7:46028. [PMID: 28393843 PMCID: PMC5385495 DOI: 10.1038/srep46028] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 03/08/2017] [Indexed: 11/16/2022] Open
Abstract
Following the end-Permian extinction, terrestrial vertebrate diversity recovered by the Middle Triassic, and that diversity was now dominated by reptiles. However, those reptilian clades, including archosaurs and their closest relatives, are not commonly found until ~30 million years post-extinction in Late Triassic deposits despite time-calibrated phylogenetic analyses predicting an Early Triassic divergence for those clades. One of these groups from the Late Triassic, Phytosauria, is well known from a near-Pangean distribution, and this easily recognized clade bears an elongated rostrum with posteriorly retracted nares and numerous postcranial synapomorphies that are unique compared with all other contemporary reptiles. Here, we recognize the exquisitely preserved, nearly complete skeleton of Diandongosuchus fuyuanensis from the Middle Triassic of China as the oldest and basalmost phytosaur. The Middle Triassic age and lack of the characteristically-elongated rostrum fill a critical morphological and temporal gap in phytosaur evolution, indicating that the characteristic elongated rostrum of phytosaurs appeared subsequent to cranial and postcranial modifications associated with enhanced prey capture, predating that general trend of morphological evolution observed within Crocodyliformes. Additionally, Diandongosuchus supports that the clade was present across Pangea, suggesting early ecosystem exploration for Archosauriformes through nearshore environments and leading to ease of dispersal across the Tethys.
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Brookes VJ, Barry SC, Hernández-Jover M, Ward MP. Point of truth calibration for disease prioritisation-A case study of prioritisation of exotic diseases for the pig industry in Australia. Prev Vet Med 2017; 139:20-32. [PMID: 28364829 DOI: 10.1016/j.prevetmed.2017.01.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Revised: 01/12/2017] [Accepted: 01/31/2017] [Indexed: 11/26/2022]
Abstract
The objective of this study was to trial point of truth calibration (POTCal) as a novel method for disease prioritisation. To illustrate the application of this method, we used a previously described case-study of prioritisation of exotic diseases for the pig industry in Australia. Disease scenarios were constructed from criteria which described potential impact and pig-producers were asked to score the importance of each scenario. POTCal was used to model participants' estimates of disease importance as a function of the criteria, to derive a predictive model to prioritise a range of exotic diseases. The best validation of producers' estimates was achieved using a model derived from all responses. The highest weighted criteria were attack rate, case fatality rate and market loss, and the highest priority diseases were the vesicular diseases followed by swine fevers and zoonotic encephalitides. Comparison of results with a previous study in which probabilistic inversion was used to prioritise diseases for the same group of producers highlighted differences between disease prioritisation methods. Overall, this study demonstrated that POTCal can be used for disease prioritisation. An advantage of POTCal is that valid models can be developed that reflect decision-makers' heuristics. Specifically, this evaluation of the use of POTCal in animal health illustrates how the judgements of participants can be incorporated into a decision-making process. Further research is needed to investigate the influence of scenarios presented to participants during POTCal evaluations, and the robustness of this approach applied to different disease issues (e.g. exotic versus endemic) and production types (e.g. intensive versus extensive). To our knowledge, this is the first report of the use of POTCal for disease prioritisation.
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Affiliation(s)
- V J Brookes
- Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, Camden, NSW, Australia.
| | - S C Barry
- Biosecurity Flagship, Commonwealth Science and Industrial Research Organisation, Canberra, Australia
| | - M Hernández-Jover
- Graham Centre for Agricultural Innovation, Charles Sturt University, Wagga Wagga, NSW, Australia
| | - M P Ward
- Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, Camden, NSW, Australia
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O'Brien EC, Taft R, Geary K, Ciotti M, Suk JE. Best practices in ranking communicable disease threats: a literature review, 2015. ACTA ACUST UNITED AC 2017; 21:30212. [PMID: 27168585 DOI: 10.2807/1560-7917.es.2016.21.17.30212] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Accepted: 11/09/2015] [Indexed: 12/23/2022]
Abstract
The threat of serious, cross-border communicable disease outbreaks in Europe poses a significant challenge to public health and emergency preparedness because the relative likelihood of these threats and the pathogens involved are constantly shifting in response to a range of changing disease drivers. To inform strategic planning by enabling effective resource allocation to manage the consequences of communicable disease outbreaks, it is useful to be able to rank and prioritise pathogens. This paper reports on a literature review which identifies and evaluates the range of methods used for risk ranking. Searches were performed across biomedical and grey literature databases, supplemented by reference harvesting and citation tracking. Studies were selected using transparent inclusion criteria and underwent quality appraisal using a bespoke checklist based on the AGREE II criteria. Seventeen studies were included in the review, covering five methodologies. A narrative analysis of the selected studies suggests that no single methodology was superior. However, many of the methods shared common components, around which a 'best-practice' framework was formulated. This approach is intended to help inform decision makers' choice of an appropriate risk-ranking study design.
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Kiiskinen SJ, Ojanen T, Björkman Y, Laitinen H, Siitonen A. External Quality Assessment in the Evaluation of Laboratory Performance of Faecal Culture. Microbiol Insights 2017; 10:1178636117691253. [PMID: 28469461 PMCID: PMC5348086 DOI: 10.1177/1178636117691253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 01/05/2017] [Indexed: 11/17/2022] Open
Abstract
In Finland, all laboratories carrying out diagnostics of infectious diseases in humans are approved by the Regional State Administrative Agencies and are obligated to participate in External Quality Assurance rounds. Performance in these rounds is thought to reflect the quality of laboratory work. In the 6-year study period, 17 Finnish laboratories received 48 simulated faecal specimens for the culturing of diarrhoeal pathogens, yielding altogether 586 faecal culture External Quality Control specimens and 581 reports. The results were correct in 92% of all reports and in 67% of all specimens. False-negative Salmonella results were given for 2 of the 18 specimens, one with biochemically atypical Salmonella strain and the other with a low count of Salmonella cells. False-negative Shigella report was given for 6 of the 7 specimens in some participating laboratory. Detection of all common faecal pathogens is especially relevant to patient safety, public health, and epidemiological surveillance.
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Affiliation(s)
- Salla J Kiiskinen
- Bacterial Infections Unit, Department of Infectious Diseases, National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Tarja Ojanen
- Bacterial Infections Unit, Department of Infectious Diseases, National Institute for Health and Welfare (THL), Helsinki, Finland
| | | | | | - Anja Siitonen
- Bacterial Infections Unit, Department of Infectious Diseases, National Institute for Health and Welfare (THL), Helsinki, Finland
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O’Brien D, Scudamore J, Charlier J, Delavergne M. DISCONTOOLS: a database to identify research gaps on vaccines, pharmaceuticals and diagnostics for the control of infectious diseases of animals. BMC Vet Res 2017; 13:1. [PMID: 28049469 PMCID: PMC5209808 DOI: 10.1186/s12917-016-0931-1] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Accepted: 12/17/2016] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The public and private sector in the EU spend around €800 million per year on animal health and welfare related research. An objective process to identify critical gaps in knowledge and available control tools should aid the prioritisation of research in order to speed up the development of new or improved diagnostics, vaccines and pharmaceuticals and reduce the burden of animal diseases. METHOD Here, we describe the construction of a database based on expert consultation for 52 infectious diseases of animals. RESULTS For each disease, an expert group produced a disease and product analysis document that formed the basis for gap analysis and prioritisation. The prioritisation model was based on a closed scoring system, employing identical weights for six evaluation criteria (disease knowledge; impact on animal health and welfare; impact on public health; impact on wider society; impact on trade; control tools). The diseases were classified into three groups: epizootic diseases, food-producing animal complexes or zoonotic diseases. DISCUSSION The highly ranked diseases in the prioritisation model comprised mostly zoonotic and epizootic diseases with important gaps identified in vaccine development and pharmaceuticals, respectively. The most important outcome is the identification of key research needs by disease. The rankings and research needs by disease are provided on a public website ( www.discontools.eu ) which is currently being updated based on new expert consultations. CONCLUSION As such, it can become a reference point for funders of research including the European Commission, member states, foundations, trusts along with private industry to prioritise research. This will deliver benefits in terms of animal health and welfare but also public health, societal benefits and a safe and secure food supply.
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Affiliation(s)
- Declan O’Brien
- International Federation for Animal Health Europe, Avenue de Tervueren 168, box 8, 1150 Brussels, Belgium
| | - Jim Scudamore
- Institute of Infection and Global Health, University of Liverpool, Liverpool, UK
| | | | - Morgane Delavergne
- International Federation for Animal Health Europe, Avenue de Tervueren 168, box 8, 1150 Brussels, Belgium
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Rezza G, Ippolito G, Brave A, Ippolito G, Jacob D, Jureen P, Bartolini B, Di Caro A. Prioritization of High Consequence Viruses to Improve European Laboratory Preparedness for Cross-Border Health Threats. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2016; 972:123-129. [PMID: 28032326 PMCID: PMC7120423 DOI: 10.1007/5584_2016_152] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Highly infectious diseases can spread rapidly across borders through travel or trade, and international coordination is essential to a prompt and efficient response by public health laboratories. Therefore, developing strategies to identify priorities for a rational allocation of resources for research and surveillance has been the focus of a large body of research in recent years. This paper describes the activities and the strategy used by a European-wide consortium funded by the European Commission, named EMERGE (Efficient response to highly dangerous and emerging pathogens at EU level), for the selection of high-threat pathogens with cross-border potential that will become the focus of its preparedness activities. The approach used is based on an objective scoring system, a close collaboration with other networks dealing with highly infection diseases, and a diagnostic gaps analysis. The result is a tool that is simple, objective and adaptable, which will be used periodically to re-evaluate activities and priorities, representing a step forward towards a better response to infectious disease emergencies.
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Affiliation(s)
- Giovanni Rezza
- 0000 0000 9120 6856grid.416651.1Istituto Superiore di Sanità IRCCS, Roma, Italy
| | - Giuseppe Ippolito
- 0000 0004 1760 4142grid.419423.9IRCCS, National Institute for Infectious Diseases, Roma, Italy
| | | | - Giuseppe Ippolito
- 'L. Spallanzani' National Institute for Infectious Diseases (INMI), Rome, Italy
| | | | | | - Barbara Bartolini
- 'L. Spallanzani' National Institute for Infectious Diseases (INMI), Rome, Italy
| | - Antonino Di Caro
- 'L. Spallanzani' National Institute for Infectious Diseases (INMI), Rome, Italy.
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Cassini A, Colzani E, Kramarz P, Kretzschmar ME, Takkinen J. Impact of food and water-borne diseases on European population health. Curr Opin Food Sci 2016. [DOI: 10.1016/j.cofs.2016.06.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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