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Buis DTP, van der Vaart TW, Prins JM, van der Meer JTM, Bonten MJM, Sieswerda E, van Werkhoven CH, Sigaloff KCE. Correction to: Comparative effectiveness of β-lactams for empirical treatment of methicillin-susceptible Staphylococcus aureus bacteraemia: a prospective cohort study. J Antimicrob Chemother 2024; 79:476. [PMID: 38078830 PMCID: PMC10832581 DOI: 10.1093/jac/dkad385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024] Open
Affiliation(s)
- D T P Buis
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Internal Medicine, Division of Infectious Diseases, Amsterdam Institute for Infection and Immunity, De Boelelaan 1117, Amsterdam, The Netherlands
| | - T W van der Vaart
- Julius Center for Health Sciences and Primary Care, UMC Utrecht, Utrecht University, Utrecht, the Netherlands
- Amsterdam UMC, Universiteit van Amsterdam, Department of Internal Medicine, Division of Infectious Diseases, Amsterdam, the Netherlands
| | - J M Prins
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Internal Medicine, Division of Infectious Diseases, Amsterdam Institute for Infection and Immunity, De Boelelaan 1117, Amsterdam, The Netherlands
| | - J T M van der Meer
- Amsterdam UMC, Universiteit van Amsterdam, Department of Internal Medicine, Division of Infectious Diseases, Amsterdam, the Netherlands
| | - M J M Bonten
- Julius Center for Health Sciences and Primary Care, UMC Utrecht, Utrecht University, Utrecht, the Netherlands
- Department of Medical Microbiology, University Medical Centre Utrecht, Utrecht University, Utrecht, the Netherlands
| | - E Sieswerda
- Julius Center for Health Sciences and Primary Care, UMC Utrecht, Utrecht University, Utrecht, the Netherlands
- Department of Medical Microbiology, University Medical Centre Utrecht, Utrecht University, Utrecht, the Netherlands
| | - C H van Werkhoven
- Julius Center for Health Sciences and Primary Care, UMC Utrecht, Utrecht University, Utrecht, the Netherlands
| | - K C E Sigaloff
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Internal Medicine, Division of Infectious Diseases, Amsterdam Institute for Infection and Immunity, De Boelelaan 1117, Amsterdam, The Netherlands
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Buis DTP, van der Vaart TW, Prins JM, van der Meer JTM, Bonten MJM, Sieswerda E, van Werkhoven CH, Sigaloff KCE, Herpers BL, Jansen RR, Rozemeijer W, Soetekouw R, van Twillert G, Veenstra J. Comparative effectiveness of β-lactams for empirical treatment of methicillin-susceptible Staphylococcus aureus bacteraemia: a prospective cohort study. J Antimicrob Chemother 2023; 78:1175-1181. [PMID: 36897327 PMCID: PMC10154124 DOI: 10.1093/jac/dkad057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 02/19/2023] [Indexed: 03/11/2023] Open
Abstract
OBJECTIVES Standard once-daily dosing of ceftriaxone may not lead to adequate antibiotic exposure in all cases of Staphylococcus aureus bacteraemia (SAB). Therefore, we compared clinical effectiveness of empirical antibiotic treatment with flucloxacillin, cefuroxime and ceftriaxone in adult patients with MSSA bacteraemia. METHODS We analysed data from the Improved Diagnostic Strategies in Staphylococcus aureus bacteraemia (IDISA) study, a multicentre prospective cohort study of adult patients with MSSA bacteraemia. Duration of bacteraemia and 30 day SAB-related mortality were compared between the three groups using multivariable mixed-effects Cox regression analyses. RESULTS In total, 268 patients with MSSA bacteraemia were included in the analyses. Median duration of empirical antibiotic therapy was 3 (IQR 2-3) days in the total study population. Median duration of bacteraemia was 1.0 (IQR 1.0-3.0) day in the flucloxacillin, cefuroxime and ceftriaxone groups. In multivariable analyses, neither ceftriaxone nor cefuroxime was associated with increased duration of bacteraemia compared with flucloxacillin (HR 1.08, 95% CI 0.73-1.60 and HR 1.22, 95% CI 0.88-1.71). In multivariable analysis, neither cefuroxime nor ceftriaxone was associated with higher 30 day SAB-related mortality compared with flucloxacillin [subdistribution HR (sHR) 1.37, 95% CI 0.42-4.52 and sHR 1.93, 95% CI 0.67-5.60]. CONCLUSIONS In this study, we could not demonstrate a difference in duration of bacteraemia and 30 day SAB-related mortality between patients with SAB empirically treated with flucloxacillin, cefuroxime or ceftriaxone. Since sample size was limited, it is possible the study was underpowered to find a clinically relevant effect.
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Affiliation(s)
- D T P Buis
- Department of Internal Medicine, Division of Infectious Diseases, Amsterdam Institute for Infection and Immunity, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands
| | - T W van der Vaart
- Julius Center for Health Sciences and Primary Care, UMC Utrecht, Utrecht University, Utrecht, the Netherlands.,Department of Internal Medicine, Division of Infectious Diseases, Amsterdam UMC, Universiteit van Amsterdam, Amsterdam, the Netherlands
| | - J M Prins
- Department of Internal Medicine, Division of Infectious Diseases, Amsterdam Institute for Infection and Immunity, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands
| | - J T M van der Meer
- Department of Internal Medicine, Division of Infectious Diseases, Amsterdam UMC, Universiteit van Amsterdam, Amsterdam, the Netherlands
| | - M J M Bonten
- Julius Center for Health Sciences and Primary Care, UMC Utrecht, Utrecht University, Utrecht, the Netherlands.,Department of Medical Microbiology, University Medical Centre Utrecht, Utrecht University, Utrecht, the Netherlands
| | - E Sieswerda
- Julius Center for Health Sciences and Primary Care, UMC Utrecht, Utrecht University, Utrecht, the Netherlands.,Department of Medical Microbiology, University Medical Centre Utrecht, Utrecht University, Utrecht, the Netherlands
| | - C H van Werkhoven
- Julius Center for Health Sciences and Primary Care, UMC Utrecht, Utrecht University, Utrecht, the Netherlands
| | - K C E Sigaloff
- Department of Internal Medicine, Division of Infectious Diseases, Amsterdam Institute for Infection and Immunity, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands
| | - B L Herpers
- Regional Public Health Laboratory Kennemerland, Haarlem, The Netherlands
| | - R R Jansen
- Department of Medical Microbiology, OLVG, Amsterdam, The Netherlands
| | - W Rozemeijer
- Department of Medical Microbiology, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands
| | - R Soetekouw
- Department of Internal Medicine, Spaarne Gasthuis, Haarlem, The Netherlands
| | - G van Twillert
- Department of Internal Medicine, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands
| | - J Veenstra
- Department of Internal Medicine, OLVG, Amsterdam, The Netherlands
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3
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Boerekamps A, Newsum AM, Smit C, Arends JE, Richter C, Reiss P, Rijnders BJA, Brinkman K, van der Valk M, Godfried MH, Goorhuis A, Hovius JW, van der Meer JTM, Kuijpers TW, Nellen FJB, van der Poll DT, Prins JM, van Vugt HJM, Wiersinga WJ, Wit FWMN, van Duinen M, van Eden J, van Hes AMH, Mutschelknauss M, Nobel HE, Pijnappel FJJ, Weijsenfeld AM, Jurriaans S, Back NKT, Zaaijer HL, Berkhout B, Cornelissen MTE, Schinkel CJ, Wolthers KC, van den Berge M, Stegeman A, Baas S, de Looff LH, Wintermans B, Veenemans J, Pronk MJH, Ammerlaan HSM, de Munnik ES, Jansz AR, Tjhie J, Wegdam MCA, Deiman B, Scharnhorst V, van Eeden A, v d V M, Brokking W, Groot M, Elsenburg LJM, Damen M, Kwa IS, van Kasteren MEE, Brouwer AE, van Erve R, de Kruijf-van de Wiel BAFM, Keelan-Pfaf S, van der Ven B, de Kruijf-van de Wiel BAFM, van der Ven B, Buiting AGM, Kabel PJ, Versteeg D, van der Ende ME, Bax HI, van Gorp ECM, Nouwen JL, Schurink CAM, Verbon A, de Vries-Sluijs TEMS, de Jong-Peltenburg NC, Bassant N, van Beek JEA, Vriesde M, van Zonneveld LM, van den Berg-Cameron HJ, de Groot J, de Zeeuw-de Man M, Boucher CAB, Koopmans MPG, van Kampen JJA, Pas SD, Branger J, Rijkeboer-Mes A, Duijf-van de Ven CJHM, Schippers EF, van Nieuwkoop C, van IJperen JM, Geilings J, van der Hut G, van Burgel ND, Haag D, Leyten EMS, Gelinck LBS, van Hartingsveld AY, Meerkerk C, Wildenbeest GS, Heikens E, Groeneveld PHP, Bouwhuis JW, Lammers AJJ, Kraan S, van Hulzen AGW, van der Bliek GL, Bor PCJ, Bloembergen P, Wolfhagen MJHM, Ruijs GJHM, Kroon FP, de Boer MGJ, Scheper H, Jolink H, Vollaard AM, Dorama W, van Holten N, Claas ECJ, Wessels E, den Hollander JG, Pogany K, Roukens A, Kastelijns M, Smit JV, Smit E, Struik-Kalkman D, Tearno C, van Niekerk T, Pontesilli O, Lowe SH, Oude Lashof AML, Posthouwer D, Ackens RP, Burgers K, Schippers J, Weijenberg-Maes B, van Loo IHM, Havenith TRA, Mulder JW, Vrouenraets SME, Lauw FN, van Broekhuizen MC, Vlasblom DJ, Smits PHM, Weijer S, El Moussaoui R, Bosma AS, van Vonderen MGA, van Houte DPF, Kampschreur LM, Dijkstra K, Faber S, Weel J, Kootstra GJ, Delsing CE, van der Burg-van de Plas M, Heins H, Lucas E, Kortmann W, van Twillert G, Renckens R, Ruiter-Pronk D, van Truijen-Oud FA, Cohen Stuart JWT, IJzerman EP, Jansen R, Rozemeijer W, van der Reijden WA, van den Berk GEL, Blok WL, Frissen PHJ, Lettinga KD, Schouten WEM, Veenstra J, Brouwer CJ, Geerders GF, Hoeksema K, Kleene MJ, van der Meché IB, Spelbrink M, Toonen AJM, Wijnands S, Kwa D, Regez R, van Crevel R, Keuter M, van der Ven AJAM, ter Hofstede HJM, Dofferhoff ASM, Hoogerwerf J, Grintjes-Huisman KJT, de Haan M, Marneef M, Hairwassers A, Rahamat-Langendoen J, Stelma FF, Burger D, Gisolf EH, Hassing RJ, Claassen M, ter Beest G, van Bentum PHM, Langebeek N, Tiemessen R, Swanink CMA, van Lelyveld SFL, Soetekouw R, van der Prijt LMM, van der Swaluw J, Bermon N, van der Reijden WA, Jansen R, Herpers BL, Veenendaal D, Verhagen DWM, van Wijk M, Bierman WFW, Bakker M, Kleinnijenhuis J, Kloeze E, Stienstra Y, Wilting KR, Wouthuyzen-Bakker M, Boonstra A, van der Meulen PA, de Weerd DA, Niesters HGM, van Leer-Buter CC, Knoester M, Hoepelman AIM, Barth RE, Bruns AHW, Ellerbroek PM, Mudrikova T, Oosterheert JJ, Schadd EM, Wassenberg MWM, van Zoelen MAD, Aarsman K, van Elst-Laurijssen DHM, de Kroon I, van Rooijen CSAM, van Berkel M, van Rooijen CSAM, Schuurman R, Verduyn-Lunel F, Wensing AMJ, Peters EJG, van Agtmael MA, Bomers M, Heitmuller M, Laan LM, Ang CW, van Houdt R, Pettersson AM, Vandenbroucke-Grauls CMJE, Reiss P, Bezemer DO, van Sighem AI, Smit C, Wit FWMN, Boender TS, Zaheri S, Hillebregt M, de Jong A, Bergsma D, Grivell S, Jansen A, Raethke M, Meijering R, Rutkens T, de Groot L, van den Akker M, Bakker Y, Bezemer M, Claessen E, El Berkaoui A, Geerlinks J, Koops J, Kruijne E, Lodewijk C, van der Meer R, Munjishvili L, Paling F, Peeck B, Ree C, Regtop R, Ruijs Y, Schoorl M, Timmerman A, Tuijn E, Veenenberg L, van der Vliet S, Wisse A, de Witte EC, Woudstra T, Tuk B. High Treatment Uptake in Human Immunodeficiency Virus/Hepatitis C Virus-Coinfected Patients After Unrestricted Access to Direct-Acting Antivirals in the Netherlands. Clin Infect Dis 2019; 66:1352-1359. [PMID: 29186365 DOI: 10.1093/cid/cix1004] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 11/20/2017] [Indexed: 12/24/2022] Open
Abstract
Background The Netherlands has provided unrestricted access to direct-acting antivirals (DAAs) since November 2015. We analyzed the nationwide hepatitis C virus (HCV) treatment uptake among patients coinfected with human immunodeficiency virus (HIV) and HCV. Methods Data were obtained from the ATHENA HIV observational cohort in which >98% of HIV-infected patients ever registered since 1998 are included. Patients were included if they ever had 1 positive HCV RNA result, did not have spontaneous clearance, and were known to still be in care. Treatment uptake and outcome were assessed. When patients were treated more than once, data were included from only the most recent treatment episode. Data were updated until February 2017. In addition, each treatment center was queried in April 2017 for a data update on DAA treatment and achieved sustained virological response. Results Of 23574 HIV-infected patients ever linked to care, 1471 HCV-coinfected patients (69% men who have sex with men, 15% persons who [formerly] injected drugs, and 15% with another HIV transmission route) fulfilled the inclusion criteria. Of these, 87% (1284 of 1471) had ever initiated HCV treatment between 2000 and 2017, 76% (1124 of 1471) had their HCV infection cured; DAA treatment results were pending in 6% (92 of 1471). Among men who have sex with men, 83% (844 of 1022) had their HCV infection cured, and DAA treatment results were pending in 6% (66 of 1022). Overall, 187 patients had never initiated treatment, DAAs had failed in 14, and a pegylated interferon-alfa-based regimen had failed in 54. Conclusions Fifteen months after unrestricted DAA availability the majority of HIV/HCV-coinfected patients in the Netherlands have their HCV infection cured (76%) or are awaiting DAA treatment results (6%). This rapid treatment scale-up may contribute to future HCV elimination among these patients.
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Affiliation(s)
- Anne Boerekamps
- Department of Internal Medicine and Infectious Diseases, Erasmus Medical Center, Rotterdam
| | - Astrid M Newsum
- Department of Infectious Diseases Research and Prevention, Public Health Service of Amsterdam.,Division of Infectious Diseases, Amsterdam Infection and Immunity Institute, Academic Medical Center
| | | | - Joop E Arends
- Department of Internal Medicine, Section Infectious Diseases, University Medical Center Utrecht
| | - Clemens Richter
- Department of Internal Medicine and Infectious Diseases, Rijnstate Hospital, Arnhem
| | - Peter Reiss
- Division of Infectious Diseases, Amsterdam Infection and Immunity Institute, Academic Medical Center.,Stichting HIV Monitoring, Amsterdam.,Department of Global Health, Academic Medical Center and Amsterdam Institute for Global Health and Development
| | - Bart J A Rijnders
- Department of Internal Medicine and Infectious Diseases, Erasmus Medical Center, Rotterdam
| | - Kees Brinkman
- Department of Internal Medicine and Infectious Diseases, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands
| | - Marc van der Valk
- Division of Infectious Diseases, Amsterdam Infection and Immunity Institute, Academic Medical Center
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Willemse SB, Baak LC, Kuiken SD, van der Sluys Veer A, Lettinga KD, van der Meer JTM, Depla ACTM, Tuynman H, van Nieuwkerk CMJ, Schinkel CJ, Kwa D, Reesink HW, van der Valk M. Sofosbuvir plus simeprevir for the treatment of HCV genotype 4 patients with advanced fibrosis or compensated cirrhosis is highly efficacious in real life. J Viral Hepat 2016; 23:950-954. [PMID: 27405785 DOI: 10.1111/jvh.12567] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 05/12/2016] [Indexed: 01/08/2023]
Abstract
Chronic hepatitis C virus (HCV) infection is a major cause of chronic liver disease and liver-related death. Recently, multiple regimens of different direct-acting antiviral agents (DAAs) have been registered. Although treatment with sofosbuvir (SOF) and simeprevir (SMV) is registered for the treatment of genotype 4 patients in some countries, data on efficacy of this combination are lacking. We aimed to assess the efficacy of SOF and SMV with or without RBV during 12 weeks in a real-life cohort of genotype 4 HCV patients. A retrospective multicentre observational study was conducted in 4 hospitals in Amsterdam, the Netherlands, including patients with advanced liver fibrosis or liver cirrhosis treated with SOF plus SMV with or without RBV during 12 weeks for a genotype 4 chronic HCV infection from 1 January 2015 to 1 August 2015. Sustained viral response (SVR) was established at week 12 after end of treatment. A total of 53 patients with genotype 4 HCV infection, treatment naïve and experienced, were included. SVR was achieved in 49 of 53 patients (92%). The four failures all had a virological relapse and did not receive ribavirin. Three were nonresponder to earlier interferon-based treatment, and one was treatment naive. In this real-life cohort of patients with HCV genotype 4 infection and advanced liver fibrosis/cirrhosis, we show that treatment with SOF and SMV is effective. The addition of RBV could be considered in treatment-experienced patients as recommended in guidelines.
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Affiliation(s)
- S B Willemse
- Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, the Netherlands
| | - L C Baak
- Department of Gastroenterology and Hepatology, Onze Lieve Vrouwe Gasthuis locatie Oost, Amsterdam, the Netherlands
| | - S D Kuiken
- Department of Gastroenterology and Hepatology, Onze Lieve Vrouwe Gasthuis locatie West, Amsterdam, the Netherlands
| | - A van der Sluys Veer
- Department of Gastroenterology and Hepatology, Onze Lieve Vrouwe Gasthuis locatie Oost, Amsterdam, the Netherlands
| | - K D Lettinga
- Department of Internal Medicine, Onze Lieve Vrouwe Gasthuis locatie West, Amsterdam, the Netherlands
| | - J T M van der Meer
- Department of Infectious Diseases, CINIMA, Academic Medical Center, Amsterdam, the Netherlands
| | - A C T M Depla
- Department of Gastroenterology and Hepatology, Slotervaart Ziekenhuis, Amsterdam, the Netherlands
| | - H Tuynman
- Department of Gastroenterology and Hepatology, Slotervaart Ziekenhuis, Amsterdam, the Netherlands
| | - C M J van Nieuwkerk
- Department of Gastroenterology and Hepatology, VU Medical Center, Amsterdam, the Netherlands
| | - C J Schinkel
- Department of Medical Microbiology, Section of Clinical Virology, Academic Medical Center, Amsterdam, the Netherlands
| | - D Kwa
- Department of Medical Microbiology, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands
| | - H W Reesink
- Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, the Netherlands
| | - M van der Valk
- Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, the Netherlands.,Department of Infectious Diseases, CINIMA, Academic Medical Center, Amsterdam, the Netherlands
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5
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Hullegie SJ, van den Berk GEL, Leyten EMS, Arends JE, Lauw FN, van der Meer JTM, Posthouwer D, van Eeden A, Koopmans PP, Richter C, van Kasteren MEE, Kroon FP, Bierman WFW, Groeneveld PHP, Lettinga KD, Soetekouw R, Peters EJG, Verhagen DWM, van Sighem AI, Claassen MAA, Rijnders BJA. Acute hepatitis C in the Netherlands: characteristics of the epidemic in 2014. Clin Microbiol Infect 2015; 22:209.e1-209.e3. [PMID: 26482267 DOI: 10.1016/j.cmi.2015.10.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Revised: 10/07/2015] [Accepted: 10/09/2015] [Indexed: 10/22/2022]
Abstract
Within the Dutch Acute HCV in HIV Study, a surveillance system was initiated to estimate the incidence of hepatitis C virus (HCV) infections in 2014. Following the Dutch HIV treatment guidelines, HIV-positive men having sex with men (MSM) in 19 participating centers were screened. Ninety-nine acute HCV infections were reported, which resulted in a mean incidence of 11 per 1000 patient-years of follow-up. Unfortunately, the HCV epidemic among Dutch HIV-positive MSM is not coming to a halt.
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Affiliation(s)
- S J Hullegie
- Department of Internal Medicine and Infectious Diseases, Erasmus MC, Rotterdam, The Netherlands.
| | - G E L van den Berk
- Department of Internal Medicine and Infectious Diseases, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands
| | - E M S Leyten
- Department of Internal Medicine and Infectious Diseases, Medisch Centrum Haaglanden, Den Haag, The Netherlands
| | - J E Arends
- Department of Internal Medicine and Infectious Diseases, Universitair Medisch Centrum Utrecht, Utrecht, The Netherlands
| | - F N Lauw
- Department of Internal Medicine and Infectious Diseases, Slotervaart Ziekenhuis, Amsterdam, The Netherlands
| | - J T M van der Meer
- Department of Internal Medicine and Infectious Diseases, Academisch Medisch Centrum, Amsterdam, The Netherlands
| | - D Posthouwer
- Department of Internal Medicine and Infectious Diseases, Maastricht Universitair Medisch Centrum, Maastricht, The Netherlands
| | | | - P P Koopmans
- Department of Internal Medicine and Infectious Diseases, Radboud Universitair Medisch Centrum, Nijmegen, The Netherlands
| | - C Richter
- Department of Internal Medicine and Infectious Diseases, Rijnstate Ziekenhuis, Arnhem, The Netherlands
| | - M E E van Kasteren
- Department of Internal Medicine and Infectious Diseases, Elisabeth Ziekenhuis, Tilburg, The Netherlands
| | - F P Kroon
- Department of Internal Medicine and Infectious Diseases, Leids Universitair Medisch Centrum, Leiden, The Netherlands
| | - W F W Bierman
- Department of Internal Medicine and Infectious Diseases, University of Groningen, Universitair Medisch Centrum Groningen, Groningen, The Netherlands
| | - P H P Groeneveld
- Department of Internal Medicine and Infectious Diseases, Isala Klinieken, Zwolle, The Netherlands
| | - K D Lettinga
- Department of Internal Medicine and Infectious Diseases, Sint Lucas Andreas Ziekenhuis, Amsterdam, The Netherlands
| | - R Soetekouw
- Department of Internal Medicine and Infectious Diseases, Kennemer Gasthuis, Haarlem, The Netherlands
| | - E J G Peters
- Department of Internal Medicine and Infectious Diseases, VU Medisch Centrum, Amsterdam, The Netherlands
| | - D W M Verhagen
- Department of Internal Medicine and Infectious Diseases, Jan van Goyen Kliniek, Amsterdam
| | | | - M A A Claassen
- Department of Internal Medicine and Infectious Diseases, Erasmus MC, Rotterdam, The Netherlands
| | - B J A Rijnders
- Department of Internal Medicine and Infectious Diseases, Erasmus MC, Rotterdam, The Netherlands
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6
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Vanhommerig JW, Lambers FAE, Schinkel J, Geskus RB, Arends JE, van de Laar TJW, Lauw FN, Brinkman K, Gras L, Rijnders BJA, van der Meer JTM, Prins M, van der Meer JTM, Molenkamp R, Mutschelknauss M, Nobel HE, Reesink HW, Schinkel J, van der Valk M, van den Berk GEL, Brinkman K, Kwa D, van der Meche N, Toonen A, Vos D, van Broekhuizen M, Lauw FN, Mulder JW, Arends JE, van Kessel A, de Kroon I, Boonstra A, van der Ende ME, Hullegie S, Rijnders BJA, van de Laar TJW, Gras L, Smit C, Lambers FAE, Prins M, Vanhommerig JW, van der Veldt W. Risk Factors for Sexual Transmission of Hepatitis C Virus Among Human Immunodeficiency Virus-Infected Men Who Have Sex With Men: A Case-Control Study. Open Forum Infect Dis 2015; 2:ofv115. [PMID: 26634219 PMCID: PMC4665384 DOI: 10.1093/ofid/ofv115] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Accepted: 07/28/2015] [Indexed: 12/22/2022] Open
Abstract
Background. Since 2000, incidence of sexually acquired hepatitis C virus (HCV)-infection has increased among human immunodeficiency virus (HIV)-infected men who have sex with men (MSM). To date, few case-control and cohort studies evaluating HCV transmission risk factors were conducted in this population, and most of these studies were initially designed to study HIV-related risk behavior and characteristics. Methods. From 2009 onwards, HIV-infected MSM with acute HCV infection and controls (HIV-monoinfected MSM) were prospectively included in the MOSAIC (MSM Observational Study of Acute Infection with hepatitis C) study at 5 large HIV outpatient clinics in the Netherlands. Written questionnaires were administered, covering sociodemographics, bloodborne risk factors for HCV infection, sexual behavior, and drug use. Clinical data were acquired through linkage with databases from the Dutch HIV Monitoring Foundation. For this study, determinants of HCV acquisition collected at the inclusion visit were analyzed using logistic regression. Results. Two hundred thirteen HIV-infected MSM (82 MSM with acute HCV infection and 131 MSM without) were included with a median age of 45.7 years (interquartile range [IQR], 41.0–52.2). Receptive unprotected anal intercourse (adjusted odds ratio [aOR], 5.01; 95% confidence interval [CI], 1.63–15.4), sharing sex toys (aOR, 3.62; 95% CI, 1.04–12.5), unprotected fisting (aOR, 2.57; 95% CI, 1.02–6.44), injecting drugs (aOR, 15.62; 95% CI, 1.27–192.6), sharing straws when snorting drugs (aOR, 3.40; 95% CI, 1.39–8.32), lower CD4 cell count (aOR, 1.75 per cubic root; 95% CI, 1.19–2.58), and recent diagnosis of ulcerative sexually transmitted infection (aOR, 4.82; 95% CI, 1.60–14.53) had significant effects on HCV acquisition. Conclusions. In this study, both sexual behavior and biological factors appear to independently increase the risk of HCV acquisition among HIV-infected MSM.
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Affiliation(s)
- Joost W Vanhommerig
- Department of Infectious Diseases , Public Health Service of Amsterdam ; Departments of Medical Microbiology
| | - Femke A E Lambers
- Department of Infectious Diseases , Public Health Service of Amsterdam
| | | | - Ronald B Geskus
- Department of Infectious Diseases , Public Health Service of Amsterdam ; Clinical Epidemiology, Biostatistics and Bioinformatics , Academic Medical Center , Amsterdam
| | - Joop E Arends
- Department of Internal Medicine and Infectious Diseases , University Medical Center Utrecht
| | | | - Fanny N Lauw
- Department of Internal Medicine , Slotervaart Hospital , Amsterdam
| | - Kees Brinkman
- Department of Internal Medicine , OLVG Hospital , Amsterdam
| | - Luuk Gras
- HIV Monitoring Foundation , Amsterdam
| | - Bart J A Rijnders
- Department of Internal Medicine and Infectious Diseases , Erasmus University Medical Center , Rotterdam
| | - Jan T M van der Meer
- Department of Internal Medicine , Center of Infectious Diseases and Immunology Amsterdam , Academic Medical Center , The Netherlands
| | - Maria Prins
- Department of Infectious Diseases , Public Health Service of Amsterdam ; Department of Internal Medicine , Center of Infectious Diseases and Immunology Amsterdam , Academic Medical Center , The Netherlands
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7
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Arends JE, van der Meer JTM, Posthouwer D, Kortmann W, Brinkman K, van Assen S, Smit C, van der Valk M, van der Ende M, Schinkel J, Reiss P, Richter C, Hoepelman AIM. Favourable SVR12 rates with boceprevir or telaprevir triple therapy in HIV/HCV coinfected patients. Neth J Med 2015; 73:324-330. [PMID: 26314715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND Recent publications have reported superior efficacy of telaprevir- or boceprevir-based triple therapy over conventional peginterferon-alfa/ribavirin therapy, albeit with varying rates of adverse events and treatment discontinuations in HIV/HCV coinfected patients. Therefore, the aim of this study is to describe the effectiveness of triple therapy in an HIV/HCV coinfection cohort in the Netherlands. METHODS HIV-infected patients with chronic HCV genotype 1 starting triple therapy including either boceprevir or telaprevir were enrolled, 26% had F3-F4 fibrosis. Data were assessed at Week 4, 8, 12, 24, 48 and SVR12 (i.e. absence of detectable plasma HCV RNA 12 weeks after completion of treatment). Failure was defined as discontinuation of treatment due to virological failure, adverse events or loss to follow-up. RESULTS A total of 53 HIV/HCV coinfected patients started peginterferon-alfa/ribavirin therapy with either boceprevir (n = 29) or telaprevir (n = 24). SVR12 was achieved in 19 (66%) of the boceprevir-treated and 15 (63%) of the telaprevir-treated patients. Both prior relapse and achievement of a rapid virological response were associated with a higher SVR12 rate. Non- response, breakthrough and relapse occurred in 4, 1 and 5 patients on boceprevir and 3, 2, 2 on telaprevir, respectively. One patient was lost to follow-up and one patient died due to progression of liver failure. Except for these two patients, no treatment discontinuations were observed due to adverse events. CONCLUSION In HIV/HCV coinfected patients, boceprevir or telaprevir triple therapy was well tolerated and resulted in favourable SVR12 rates comparable with previous publications concerning HCV mono-infected patients.
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Affiliation(s)
- J E Arends
- Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht (UMCU), Utrecht, the Netherlands
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8
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Schouten J, Wit FW, Stolte IG, Kootstra NA, van der Valk M, Geerlings SE, Prins M, Reiss P, Reiss P, Wit FWNM, van der Valk M, Schouten J, Kooij KW, van Zoest RA, Elsenga BC, Prins M, Stolte IG, Martens M, Moll S, Berkel J, Moller L, Visser GR, Welling C, Zaheri S, Hillebregt MMJ, Gras LAJ, Ruijs YMC, Benschop DP, Reiss P, Kootstra NA, Harskamp-Holwerda AM, Maurer I, Mangas Ruiz MM, Girigorie AF, van Leeuwen E, Janssen FR, Heidenrijk M, Schrijver JHN, Zikkenheiner W, Wezel M, Jansen-Kok CSM, Geerlings SE, Godfried MH, Goorhuis A, van der Meer JTM, Nellen FJB, van der Poll T, Prins JM, Reiss P, van der Valk M, Wiersinga WJ, Wit FWNM, van Eden J, Henderiks A, van Hes AMH, Mutschelknauss M, Nobel HE, Pijnappel FJJ, Westerman AM, de Jong J, Postema PG, Bisschop PHLT, Serlie MJM, Lips P, Dekker E, de Rooij SEJA, Willemsen JMR, Vogt L, Schouten J, Portegies P, Schmand BA, Geurtsen GJ, ter Stege JA, Klein Twennaar M, van Eck-Smit BLF, de Jong M, Richel DJ, Verbraak FD, Demirkaya N, Visser I, Ruhe HG, Nieuwkerk PT, van Steenwijk RP, Dijkers E, Majoie CBLM, Caan MWA, Su T, van Lunsen HW, Nievaard MAF, van den Born BJH, Stroes ESG, Mulder WMC. Cross-sectional Comparison of the Prevalence of Age-Associated Comorbidities and Their Risk Factors Between HIV-Infected and Uninfected Individuals: The AGEhIV Cohort Study. Clin Infect Dis 2014; 59:1787-97. [DOI: 10.1093/cid/ciu701] [Citation(s) in RCA: 498] [Impact Index Per Article: 49.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
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9
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Arends JE, Lambers FAE, van der Meer JTM, Schreij G, Richter C, Brinkman K, Hoepelman AIM. Treatment of acute hepatitis C virus infection in HIV+ patients: Dutch recommendations for management. Neth J Med 2011; 69:43-49. [PMID: 21325703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
With a rising incidence of acute hepatitis C virus (HCV) infection in patients coinfected with the human immunodeficiency virus (HIV), there is a need for evidence-based treatment recommendations. There are no randomised trials available and published studies differ with respect to design, patient characteristics and number of patients included, making a comparison between studies difficult. However, it is critical to standardise treatment for this group of patients in order to optimise the outcome of therapy. The Dutch Society for HIV Physicians proposed to write recommendations for the treatment of acute HCV in HIV -coinfected patients. Combination therapy with pegylated interferon-alpha and ribavirin is the preferred regimen initiated preferably within 12 weeks after the diagnosis of acute HCV. A treatment duration of 24 weeks is recommended in case of a favourable virological response (either achievement of a rapid virological response or a > 2 log10 decrease plus undetectable HCV-RNA at week 12). In all other patients prolonging the duration of therapy to 48 weeks should be considered.
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Affiliation(s)
- J E Arends
- Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht (UMCU), Utrecht, the Netherlands.
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10
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Slabbekoorn M, Horlings HM, van der Meer JTM, Windhausen A, van der Sloot JAP, Lagrand WK. Left-sided native valve Staphylococcus aureus endocarditis. Neth J Med 2010; 68:341-347. [PMID: 21116027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Despite improved diagnostic tools and expanded treatment options, left-sided native valve endocarditis caused by Staphylococcus aureus infection remains a serious and destructive disease. The high morbidity and mortality, however, can be reduced by early recognition, correct diagnosis, and appropriate treatment. In the following article, we discuss the clinical presentation, diagnostic workup and treatment of infective endocarditis, thereby reviewing the current guidelines. Blood cultures and echocardiography are the cornerstones of diagnosis in identifying infective endocarditis but are no substitute for clinical judgement. The modified Duke criteria may facilitate the diagnostic process, but clinical evaluation remains crucial.
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Affiliation(s)
- M Slabbekoorn
- Department of Intensive Care Medicine, Medical Centre Haaglanden, the Hague, the Netherlands.
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11
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Barth RE, van der Meer JTM, Hoepelman AIM, Schrooders PA, van de Vijver DA, Geelen SPM, Tempelman HA. Effectiveness of highly active antiretroviral therapy administered by general practitioners in rural South Africa. Eur J Clin Microbiol Infect Dis 2008; 27:977-84. [DOI: 10.1007/s10096-008-0534-2] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2007] [Accepted: 04/15/2008] [Indexed: 11/28/2022]
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12
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Verhagen DWM, Hermanides J, Korevaar JC, Bossuyt PMM, van den Brink RBA, Speelman P, van der Meer JTM. Extension of antimicrobial treatment in patients with left-sided native valve endocarditis based on elevated C-reactive protein values. Eur J Clin Microbiol Infect Dis 2007; 26:587-90. [PMID: 17566799 DOI: 10.1007/s10096-007-0319-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The aim of this non-randomized study was to investigate whether there is any benefit in the extension of antimicrobial treatment in patients with left-sided native valve endocarditis in whom C-reactive protein levels are still elevated after a standard course of therapy. There was no statistically significant difference in outcome between the group of patients in which treatment was extended in comparison to the group in which treatment was ended at the recommended time. It is unlikely that there is much to gain from extending treatment based on elevated C-reactive protein levels alone.
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Affiliation(s)
- D W M Verhagen
- Department of Infectious Diseases, Tropical Medicine & AIDS, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
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13
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van der Meer JTM. [Central catheters should be removed immediately if bacteraemia occurs]. Ned Tijdschr Geneeskd 2006; 150:1562. [PMID: 16886692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
No randomised controlled study has been conducted into the correct treatment of catheter-related bacteraemia infections. This is due to the fact that true bacteraemia is difficult to differentiate from catheter contamination. Experience in the treatment of patients who do not have bacteraemia is therefore often incorrectly extrapolated to patients who do have bacteraemia with a central catheter in situ. Removing the central catheter can reduce the risk of complications of bacteraemia.
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Affiliation(s)
- J T M van der Meer
- Academisch Medisch Centrum/Universiteit van Amsterdam, afd. Inwendige Geneeskunde, onderafd. Infectieziekten, Tropengeneeskunde en Aids, F4-2I7, Meibergdreef 9, 1105 AZ Amsterdam.
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14
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Verhagen DWM, Vedder AC, Speelman P, van der Meer JTM. Antimicrobial treatment of infective endocarditis caused by viridans streptococci highly susceptible to penicillin: historic overview and future considerations. J Antimicrob Chemother 2006; 57:819-24. [PMID: 16549513 DOI: 10.1093/jac/dkl087] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
In this article we present the path that led to current concepts regarding antimicrobial treatment of endocarditis caused by viridans streptococci highly susceptible to penicillin. Early treatment trials indicate that some patients with subacute endocarditis can be cured with shorter treatment duration than currently advised by international guidelines. Also, high-dose antibiotics, as recommended today, have a predominantly pharmacokinetic and pharmacodynamic rationale that is based mostly on experimental animal studies. Shortening antimicrobial treatment in select patients with endocarditis would be of great benefit. As yet there are no predictors of cure that can be used to individualize treatment duration in patients with bacterial endocarditis.
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Affiliation(s)
- D W M Verhagen
- Department of Internal Medicine, Division of Infectious Diseases, Tropical Medicine & AIDS, Academic Medical Centre, Amsterdam, The Netherlands
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15
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Ruys TA, den Hollander JG, Beld MGHM, van der Ende ME, van der Meer JTM. [Sexual transmission of hepatitis C in homosexual men]. Ned Tijdschr Geneeskd 2004; 148:2309-12. [PMID: 15587046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
An acute hepatitis C infection was diagnosed in three HIV-positive gay men, aged 43, 48 and 30 years, respectively. In all three, unprotected sexual intercourse and fisting was a universal risk factor for the infection. They all denied having used drugs intravenously, which is the most common risk factor. The third man had a documented proctitis (lymphogranuloma venereum) at the time when the HCV transmission must have taken place. No serious complications occurred during the acute HCV infection. Because the infection did not resolve spontaneously after a few months, all three men were treated with pegylated interferon and ribavirin. Recently, the number of cases of acute HCV infection has been seen to increase in The Netherlands. This may be due primarily to an increase in unprotected sexual intercourse and fisting. This hypothesis is supported by a documented increased prevalence of sexually transmissible diseases among gay men in The Netherlands. As acute infections may turn into chronic infections, treatment of an acute infection should be considered in order to prevent the chronic disease.
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Affiliation(s)
- Th A Ruys
- Academisch Medisch Centrum/Universiteit van Amsterdam, Postbus 22.660, 1100 DD Amsterdam.
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16
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Verhagen DWM, van der Feltz M, Plokker HWM, Buiting AGM, Tjoeng MM, van der Meer JTM. Optimisation of the antibiotic guidelines in The Netherlands. VII. SWAB guidelines for antimicrobial therapy in adult patients with infectious endocarditis. Neth J Med 2003; 61:421-9. [PMID: 15025420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
The Working Party on Antibiotic Policy (Dutch acronym is SWAB) is a Dutch organisation that develops guidelines for in-hospital antimicrobial therapy of bacterial infectious diseases. This present guideline describes the antimicrobial treatment for adult patients with infective endocarditis. The choice and duration of antimicrobial therapy is determined by the infecting micro-organism, sensitivity of this micro-organism for antimicrobial therapy, location of the endocarditis, left-sided or right-sided, and presence of intracardial prosthetic material. In this guideline, the empirical therapy for endocarditis is discussed as well as the therapy for the most frequent causative organisms: streptococci, enterococci, staphylococci and HACEK micro-organisms.
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Affiliation(s)
- D W M Verhagen
- Department Internal Medicine, Academic Medical Centre (F4-217), Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
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17
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Wever PC, Heddema ER, van Vonderen MGA, van der Meer JTM, de Jong MD, van Gool T. Detection of pneumococcemia by quantitative buffy coat analysis. Eur J Clin Microbiol Infect Dis 2003; 22:450-2. [PMID: 12827533 DOI: 10.1007/s10096-003-0956-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- P C Wever
- Section of Parasitology, Department of Medical Microbiology, Academic Medical Centre, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands.
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18
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van der Meer JTM. Prophylaxis of endocarditis. Neth J Med 2002; 60:423-7. [PMID: 12685488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
For a long time it has been known that bacteraemias caused by medical or dental procedures may cause endocarditis in patients with specific types of congenital or acquired heart disease. In the 1940s it was thought that the administration of antibiotics before such procedures would prevent endocarditis. However, the beneficial effect of this preventive measure on the incidence of endocarditis did not live up to its expectations. Quite soon it became obvious that prophylaxis was not 100% efficacious in man, although it did prevent endocarditis in animals. A controlled study into the protective effect of prophylaxis in humans has never been carried out. In the last decade it has become dear from case-control studies that endocarditis prophylaxis is not a very effective preventive measure but that it reduces an already small risk even further. In this article the theoretical background of endocarditis prophylaxis and possible explanations for its lack of effect are discussed.
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Affiliation(s)
- J T M van der Meer
- Department of Internal Medicine F4-217, Division of Infectious Diseases, Tropical Medicine and AIDS, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
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19
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van der Meer JTM. [Guidelines for endocarditis prevention revised by the Netherlands Heart Foundation]. Ned Tijdschr Tandheelkd 2002; 109:490-3. [PMID: 12572101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
The risk of endocarditis developing as the consequence of a bacteremia caused by a health care procedure in a patient with a predisposing heart disease is small. The administration of antibiotics before such a procedure is thought to reduce this risk still further. However, the protective effect of this preventive measure has never been demonstrated in a prospective randomized study. With certainty it can be said though, that it is not 100% efficacious and reports on prophylaxis failure have appeared ever since the introduction of this preventive measure. The revised guidelines are as far as possible based on published data. Where data are lacking, experts opinion was followed. The guidelines are not exhaustive and do not cover each and every circumstance in which prophylaxis could be warrantable. The purpose of the guidelines is to give the clinician something to go by in the most frequently occurring health care procedures. Not everyone will agree with the choices made by the commission in areas where data are lacking. In these areas, local directives may differ from the published directives. For a made to order advice on prophylaxis one should turn to an expert on endocarditis.
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20
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van der Vliet HJJ, van Oers MHJ, Schot LJ, Majoie CBL, van der Meer JTM. A space-occupying lesion of the skull base, masked by nasopharyngeal lymphatic tissue hypertrophy and causing cranial nerve dysfunction in an HIV-infected patient. Ann Hematol 2002; 81:164-6. [PMID: 11904744 DOI: 10.1007/s00277-002-0428-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2001] [Accepted: 01/07/2002] [Indexed: 10/27/2022]
Abstract
Patients infected with HIV are at increased risk of developing lymphoma. The lymphomas often involve extranodal sites and +/-90% are of B-cell phenotype. We describe an HIV-infected patient with unilateral multiple cranial nerve dysfunction, most likely as a result of a nasopharyngeal B-cell non-Hodgkin's lymphoma in which early histologic confirmation of the diagnosis was delayed by the simultaneous presence of nasopharyngeal lymphatic tissue hypertrophy. It is of practical importance to recognize non-Hodgkin's lymphoma as a cause of cranial nerve dysfunction and to be aware of the possibility and the implications of the simultaneous presence of nasopharyngeal lymphatic tissue hypertrophy in HIV-infected patients.
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Affiliation(s)
- H J J van der Vliet
- Department of Medicine, Division of Infectious Diseases, Tropical Medicine & AIDS, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands.
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