1
|
Heideman DAM, Berkhof J, Verhoef L, Ouwerkerk C, Smit PW, Oštrbenk Valenčak A, Mlakar J, Poljak M, Steenbergen RDM, Bleeker MCG. Validation of the clinical performance and reproducibility of the NeuMoDx HPV assay self-sample workflow. J Clin Virol 2024; 171:105649. [PMID: 38335717 DOI: 10.1016/j.jcv.2024.105649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 01/15/2024] [Accepted: 01/29/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND Human papillomavirus (HPV) testing on self-samples is a valid tool for cervical cancer screening. HPV self-sample workflows need to be clinically validated to ensure safe use in screening. OBJECTIVE This study evaluated the fully automated NeuMoDx HPV Assay self-sample workflow that is compiled of the NeuMoDx HPV assay and the NeuMoDx 96/288 Molecular Systems, for clinical performance and reproducibility on Evalyn Brush-collected self-samples. METHODS The clinical performance of the NeuMoDx HPV Assay self-sample workflow for cervical intraepithelial neoplasia grade 2 or worse (CIN2+) and CIN3+ was evaluated on 987 self-samples obtained from women attending national organized HPV-based cervical cancer screening by a noninferiority analysis relative to reference workflows using either HPV-Risk Assay or high-risk HPV GP5+/6+-PCR. Intra- and inter-laboratory reproducibility of the NeuMoDx HPV Assay self-sample workflow using both NeuMoDx 96 and 288 Molecular Systems was assessed on 520 self-samples in three laboratories. RESULTS The clinical sensitivity and specificity of the NeuMoDx HPV Assay self-sample workflow for the detection of CIN2+ and CIN3+ were found to be non-inferior to the reference workflows using either HPV-Risk Assay or high-risk HPV GP5+/6+-PCR, with all p-values <0.034. The NeuMoDx HPV Assay self-sample workflow exhibited an intra-laboratory reproducibility of 94.4 % (95 %CI:92.5-96.1 %) with kappa value 0.86 (95 %CI:0.81-0.91). Inter-laboratory agreement was high (all ≥93.4 % and all kappa values ≥0.83). CONCLUSIONS The NeuMoDx HPV Assay self-sample workflow demonstrated high clinical accuracy for CIN2+/3+ and high reproducibility. The NeuMoDx HPV Assay self-sample workflow can be considered suitable for cervical cancer screening purposes.
Collapse
Affiliation(s)
- D A M Heideman
- Amsterdam UMC location Vrije Universiteit Amsterdam, Pathology, De Boelelaan 1117, Amsterdam, Netherlands; Cancer Center Amsterdam, Imaging and Biomarkers, Amsterdam, Netherlands.
| | - J Berkhof
- Amsterdam UMC location Vrije Universiteit Amsterdam, Data Sciences, De Boelelaan 1117, Amsterdam, Netherlands
| | - L Verhoef
- Amsterdam UMC location Vrije Universiteit Amsterdam, Pathology, De Boelelaan 1117, Amsterdam, Netherlands; Cancer Center Amsterdam, Imaging and Biomarkers, Amsterdam, Netherlands
| | - C Ouwerkerk
- Amsterdam UMC location Vrije Universiteit Amsterdam, Pathology, De Boelelaan 1117, Amsterdam, Netherlands; Cancer Center Amsterdam, Imaging and Biomarkers, Amsterdam, Netherlands
| | - P W Smit
- Molecular Diagnostics Unit, Medical Microbiology, Maasstad Ziekenhuis, Rotterdam, Netherlands
| | - A Oštrbenk Valenčak
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - J Mlakar
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - M Poljak
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - R D M Steenbergen
- Amsterdam UMC location Vrije Universiteit Amsterdam, Pathology, De Boelelaan 1117, Amsterdam, Netherlands; Cancer Center Amsterdam, Imaging and Biomarkers, Amsterdam, Netherlands
| | - M C G Bleeker
- Amsterdam UMC location Vrije Universiteit Amsterdam, Pathology, De Boelelaan 1117, Amsterdam, Netherlands; Cancer Center Amsterdam, Imaging and Biomarkers, Amsterdam, Netherlands
| |
Collapse
|
2
|
Soloukey S, Collée E, Verhoef L, Satoer DD, Dirven CMF, Bos EM, Schouten JW, Generowicz BS, Mastik F, De Zeeuw CI, Koekkoek SKE, Vincent AJPE, Smits M, Kruizinga P. Human brain mapping using co-registered fUS, fMRI and ESM during awake brain surgeries: A proof-of-concept study. Neuroimage 2023; 283:120435. [PMID: 37914090 DOI: 10.1016/j.neuroimage.2023.120435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 10/15/2023] [Accepted: 10/29/2023] [Indexed: 11/03/2023] Open
Abstract
Accurate, depth-resolved functional imaging is key in both understanding and treatment of the human brain. A new sonography-based imaging technique named functional Ultrasound (fUS) uniquely combines high sensitivity with submillimeter-subsecond spatiotemporal resolution available in large fields-of-view. In this proof-of-concept study we show that: (A) fUS reveals the same eloquent regions as found by fMRI while concomitantly visualizing in-vivo microvascular morphology underlying these functional hemodynamics and (B) fUS-based functional maps are confirmed by Electrocortical Stimulation Mapping (ESM), the current gold-standard in awake neurosurgical practice. This unique cross-modality experiment was performed using motor, visual and language-related functional tasks in patients undergoing awake brain tumor resection. The current work serves as an important milestone towards further maturity of fUS as well as a novel avenue to increase our understanding of hemodynamics-based functional brain imaging.
Collapse
Affiliation(s)
- S Soloukey
- Department of Neuroscience, Erasmus MC, Wytemaweg 80 3015 CN, Rotterdam 3015 CN, the Netherlands; Department of Neurosurgery, Erasmus MC, Rotterdam 3015 CN, the Netherlands
| | - E Collée
- Department of Neurosurgery, Erasmus MC, Rotterdam 3015 CN, the Netherlands
| | - L Verhoef
- Department of Neuroscience, Erasmus MC, Wytemaweg 80 3015 CN, Rotterdam 3015 CN, the Netherlands
| | - D D Satoer
- Department of Neurosurgery, Erasmus MC, Rotterdam 3015 CN, the Netherlands
| | - C M F Dirven
- Department of Neurosurgery, Erasmus MC, Rotterdam 3015 CN, the Netherlands
| | - E M Bos
- Department of Neurosurgery, Erasmus MC, Rotterdam 3015 CN, the Netherlands
| | - J W Schouten
- Department of Neurosurgery, Erasmus MC, Rotterdam 3015 CN, the Netherlands
| | - B S Generowicz
- Department of Neuroscience, Erasmus MC, Wytemaweg 80 3015 CN, Rotterdam 3015 CN, the Netherlands
| | - F Mastik
- Department of Neuroscience, Erasmus MC, Wytemaweg 80 3015 CN, Rotterdam 3015 CN, the Netherlands
| | - C I De Zeeuw
- Department of Neuroscience, Erasmus MC, Wytemaweg 80 3015 CN, Rotterdam 3015 CN, the Netherlands; Netherlands Institute for Neuroscience, Royal Dutch Academy for Arts and Sciences, Amsterdam 1105 BA, the Netherlands
| | - S K E Koekkoek
- Department of Neuroscience, Erasmus MC, Wytemaweg 80 3015 CN, Rotterdam 3015 CN, the Netherlands
| | - A J P E Vincent
- Department of Neurosurgery, Erasmus MC, Rotterdam 3015 CN, the Netherlands
| | - M Smits
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam 3015 CN, the Netherlands
| | - P Kruizinga
- Department of Neuroscience, Erasmus MC, Wytemaweg 80 3015 CN, Rotterdam 3015 CN, the Netherlands.
| |
Collapse
|
3
|
Soloukey S, Verhoef L, Mastik F, Generowicz BS, Bos EM, Harhangi BS, Collée KE, Satoer DD, Smits M, Dirven CMF, De Zeeuw CI, Koekkoek SKE, Vincent AJPE, Kruizinga P. P09.03 Fully integrating functional Ultrasound (fUS) into the onco-neurosurgical operating room: Towards a new real-time, high-resolution image-guided resection tool with multimodal potential. Neuro Oncol 2021. [DOI: 10.1093/neuonc/noab180.091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
BACKGROUND
Onco-neurosurgical practice still relies heavily on pre-operatively acquired images to guide intra-operative decision-making for safe tumor removal, a practice with inherent pitfalls such as registration inaccuracy due to brain shift, and lack of real-time (functional) feedback. Exploiting the opportunity for real-time imaging of the exposed brain can improve intra-operative decision-making, neurosurgical safety and patient outcomes. Previously, we described functional Ultrasound (fUS) as a high-resolution, depth-resolved imaging technique able to detect functional regions and vascular morphology during awake resections. Here, we present for the first time fUS as a fully integrated, MRI/CT-registered imaging modality in the OR.
MATERIAL AND METHODS
fUS relies on high-frame-rate (HFR) ultrasound, making the technique sensitive for very small motions caused by vascular dynamics (µDoppler) and allowing measurements of changes in cerebral blood volume (CBV) with micrometer-millisecond precision. This opens up the possibility to 1) detect functional response, as CBV-changes reflect changes in metabolism of activated neurons through neurovascular coupling and 2) visualize in-vivo vascular morphology of tumor and healthy tissue. During a range of anesthetized and awake onco-neurosurgical procedures we acquired images of brain and spinal cord using conventional linear ultrasound probes connected to an experimental acquisition unit. Building on Brainlab’s ‘Cranial Navigation’ and ‘Intra-Operative Ultrasound’ modules, we could co-register our intra-operative Power Doppler Images (PDIs) to patient-registered MRI/CT-data. Using the ‘IGTLink’ research interface, we could access and store real-time tracking data for informed volume reconstructions in post-processing.
RESULTS
Intra-operative fUS could be registered to MRI/CT-images in real-time, showing overlays of PDIs at imaging depths of >5 centimeters. During meningioma resections, these co-registered PDIs revealed fUS’ ability to visualize the tumor’s feeding vessels and surrounding healthy vasculature prior to durotomy, with a level of detail unprecedented by conventional MRI-sequences. Comparing post-operatively reconstructed 3D-vascular maps of pre- and post-durotomy acquisitions, further confirmed the dural dependency of the vascular network feeding the tumor. During awake resections, fUS revealed distinct functional areas as activated during motor and language tasks.
CONCLUSION
fUS is a new real-time, high-resolution and depth-resolved imaging technique, combining characteristics uniquely beneficial for a potential image-guided resection tool. The successful integration of fUS in the onco-neurosurgical OR demonstrated by our team, is an essential step towards clinical integration of fUS, as well as the technique’s validation against modalities such as MRI and CT.
Collapse
Affiliation(s)
- S Soloukey
- Dept. of Neuroscience and Neurosurgery, Erasmus MC, Rotterdam, Netherlands
| | - L Verhoef
- Dept. of Neuroscience, Erasmus MC, Rotterdam, Netherlands
| | - F Mastik
- Dept. of Biomedical Engineering – Thorax Centre, Erasmus MC, Rotterdam, Netherlands
| | - B S Generowicz
- Dept. of Neuroscience, Erasmus MC, Rotterdam, Netherlands
| | - E M Bos
- Dept. of Neurosurgery, Erasmus MC, Rotterdam, Netherlands
| | - B S Harhangi
- Dept. of Neurosurgery, Erasmus MC, Rotterdam, Netherlands
| | - K E Collée
- Dept. of Neurosurgery, Erasmus MC, Rotterdam, Netherlands
| | - D D Satoer
- Dept. of Neurosurgery, Erasmus MC, Rotterdam, Netherlands
| | - M Smits
- Dept. of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, Netherlands
| | - C M F Dirven
- Dept. of Neurosurgery, Erasmus MC, Rotterdam, Netherlands
| | - C I De Zeeuw
- Netherlands Institute for Neuroscience (NIN), Royal Dutch Academy for Arts and Sciences (KNAW), Amsterdam and Dept. of Neuroscience, Erasmus MC, Rotterdam, Netherlands
| | - S K E Koekkoek
- Dept. of Neuroscience, Erasmus MC, Rotterdam, Netherlands
| | | | - P Kruizinga
- Dept. of Neuroscience, Erasmus MC, Rotterdam, Netherlands
| |
Collapse
|
4
|
Lac V, Verhoef L, Aguirre-Hernandez R, Nazeran TM, Tessier-Cloutier B, Praetorius T, Orr NL, Noga H, Lum A, Khattra J, Prentice LM, Co D, Köbel M, Mijatovic V, Lee AF, Pasternak J, Bleeker MC, Krämer B, Brucker SY, Kommoss F, Kommoss S, Horlings HM, Yong PJ, Huntsman DG, Anglesio MS. Iatrogenic endometriosis harbors somatic cancer-driver mutations. Hum Reprod 2019; 34:69-78. [PMID: 30428062 DOI: 10.1093/humrep/dey332] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 11/01/2018] [Indexed: 12/17/2022] Open
Abstract
STUDY QUESTION Does incisional endometriosis (IE) harbor somatic cancer-driver mutations? SUMMARY ANSWER We found that approximately one-quarter of IE cases harbor somatic-cancer mutations, which commonly affect components of the MAPK/RAS or PI3K-Akt-mTor signaling pathways. WHAT IS KNOWN ALREADY Despite the classification of endometriosis as a benign gynecological disease, it shares key features with cancers such as resistance to apoptosis and stimulation of angiogenesis and is well-established as the precursor of clear cell and endometrioid ovarian carcinomas. Our group has recently shown that deep infiltrating endometriosis (DE), a form of endometriosis that rarely undergoes malignant transformation, harbors recurrent somatic mutations. STUDY DESIGN, SIZE, DURATION In a retrospective study comparing iatrogenically induced and endogenously occurring forms of endometriosis unlikely to progress to cancer, we examined endometriosis specimens from 40 women with IE and 36 women with DE. Specimens were collected between 2004 and 2017 from five hospital sites in either Canada, Germany or the Netherlands. IE and DE cohorts were age-matched and all women presented with histologically typical endometriosis without known history of malignancy. PARTICIPANTS/MATERIALS, SETTING, METHODS Archival tissue specimens containing endometriotic lesions were macrodissected and/or laser-capture microdissected to enrich endometriotic stroma and epithelium and a hypersensitive cancer hotspot sequencing panel was used to assess for presence of somatic mutations. Mutations were subsequently validated using droplet digital PCR. PTEN and ARID1A immunohistochemistry (IHC) were performed as surrogates for somatic events resulting in functional loss of respective proteins. MAIN RESULTS AND THE ROLE OF CHANCE Overall, we detected somatic cancer-driver events in 11 of 40 (27.5%) IE cases and 13 of 36 (36.1%) DE cases, including hotspot mutations in KRAS, ERBB2, PIK3CA and CTNNB1. Heterogeneous PTEN loss occurred at similar rates in IE and DE (7/40 vs 5/36, respectively), whereas ARID1A loss only occurred in a single case of DE. While rates of detectable somatic cancer-driver events between IE and DE are not statistically significant (P > 0.05), KRAS activating mutations were more prevalent in DE. LIMITATIONS, REASONS FOR CAUTION Detection of somatic cancer-driver events were limited to hotspots analyzed in our panel-based sequencing assay and loss of protein expression by IHC from archival tissue. Whole genome or exome sequencing, or epigenetic analysis may uncover additional somatic alterations. Moreover, because of the descriptive nature of this study, the functional roles of identified mutations within the context of endometriosis remain unclear and causality cannot be established. WIDER IMPLICATIONS OF THE FINDINGS The alterations we report may be important in driving the growth and survival of endometriosis in ectopic regions of the body. Given the frequency of mutation in surgically displaced endometrium (IE), examination of similar somatic events in eutopic endometrium, as well as clinically annotated cases of other forms of endometriosis, in particular endometriomas that are most commonly linked to malignancy, is warranted. STUDY FUNDING/COMPETING INTEREST(S) This study was funded by a Canadian Cancer Society Impact Grant [701603, PI Huntsman], Canadian Institutes of Health Research Transitional Open Operating Grant [MOP-142273, PI Yong], the Canadian Institutes of Health Research Foundation Grant [FDN-154290, PI Huntsman], the Canadian Institutes of Health Research Project Grant [PJT-156084, PIs Yong and Anglesio], and the Janet D. Cottrelle Foundation through the BC Cancer Foundation [PI Huntsman]. D.G. Huntsman is a co-founder and shareholder of Contextual Genomics Inc., a for profit company that provides clinical reporting to assist in cancer patient treatment. R. Aguirre-Hernandez, J. Khattra and L.M. Prentice have a patent MOLECULAR QUALITY ASSURANCE METHODS FOR USE IN SEQUENCING pending and are current (or former) employees of Contextual Genomics Inc. The remaining authors have no competing interests to declare. TRIAL REGISTRATION NUMBER Not applicable.
Collapse
Affiliation(s)
- V Lac
- Department of Molecular Oncology, BC Cancer Research Centre, Room 3-218, 675 West 10th Ave, Vancouver, British Columbia, Canada.,Department of Pathology and Laboratory Medicine, Rm G227, 2211 Wesbrook Mall, University of British Columbia, Vancouver, British Columbia, Canada
| | - L Verhoef
- Department of Pathology of Antoni van Leeuwenhoek, Netherlands Cancer Institute, Plesmanlaan 121, CX Amsterdam, The Netherlands
| | - R Aguirre-Hernandez
- Contextual Genomics, 2389 Health Sciences Mall #204, Vancouver, British Columbia, Canada
| | - T M Nazeran
- Department of Molecular Oncology, BC Cancer Research Centre, Room 3-218, 675 West 10th Ave, Vancouver, British Columbia, Canada.,Department of Anatomical Pathology, Vancouver General Hospital, 899 W 12th Ave, Vancouver, British Columbia, Canada
| | - B Tessier-Cloutier
- Department of Pathology and Laboratory Medicine, Rm G227, 2211 Wesbrook Mall, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Anatomical Pathology, Vancouver General Hospital, 899 W 12th Ave, Vancouver, British Columbia, Canada
| | - T Praetorius
- Department of Molecular Oncology, BC Cancer Research Centre, Room 3-218, 675 West 10th Ave, Vancouver, British Columbia, Canada.,Department of Women's Health, Tuebingen University Hospital, Calwerstrasse 7, Tuebingen, Germany
| | - N L Orr
- Department of Obstetrics and Gynaecology, University of British Columbia, Suite 930, 1125 Howe Street, Vancouver, British Columbia, Canada.,BC Women's Centre for Pelvic Pain & Endometriosis, BC Women's Hospital and Health Centre, Women' Health Centre, F2-4500 Oak St, Vancouver, British Columbia, Canada
| | - H Noga
- Department of Obstetrics and Gynaecology, University of British Columbia, Suite 930, 1125 Howe Street, Vancouver, British Columbia, Canada.,BC Women's Centre for Pelvic Pain & Endometriosis, BC Women's Hospital and Health Centre, Women' Health Centre, F2-4500 Oak St, Vancouver, British Columbia, Canada
| | - A Lum
- Department of Molecular Oncology, BC Cancer Research Centre, Room 3-218, 675 West 10th Ave, Vancouver, British Columbia, Canada
| | - J Khattra
- Contextual Genomics, 2389 Health Sciences Mall #204, Vancouver, British Columbia, Canada
| | - L M Prentice
- Contextual Genomics, 2389 Health Sciences Mall #204, Vancouver, British Columbia, Canada
| | - D Co
- Department of Molecular Oncology, BC Cancer Research Centre, Room 3-218, 675 West 10th Ave, Vancouver, British Columbia, Canada
| | - M Köbel
- Department of Pathology and Laboratory Medicine, University of Calgary, 2500 University Dr NW, Calgary, Alberta, Canada
| | - V Mijatovic
- Academic Endometriosis Center VUmc, Department of Reproductive Medicine, VU University Medical Center, De Boelelaan 1117, HV Amsterdam, The Netherlands
| | - A F Lee
- Department of Pathology and Laboratory Medicine, Rm G227, 2211 Wesbrook Mall, University of British Columbia, Vancouver, British Columbia, Canada
| | - J Pasternak
- Department of Women's Health, Tuebingen University Hospital, Calwerstrasse 7, Tuebingen, Germany
| | - M C Bleeker
- Academic Endometriosis Center VUmc, Department of Reproductive Medicine, VU University Medical Center, De Boelelaan 1117, HV Amsterdam, The Netherlands
| | - B Krämer
- Department of Women's Health, Tuebingen University Hospital, Calwerstrasse 7, Tuebingen, Germany
| | - S Y Brucker
- Department of Women's Health, Tuebingen University Hospital, Calwerstrasse 7, Tuebingen, Germany
| | - F Kommoss
- Institute of Pathology, Medizin Campus Bodensee, Roentgenstrasse 2, Friedrichshafen, Germany
| | - S Kommoss
- Department of Women's Health, Tuebingen University Hospital, Calwerstrasse 7, Tuebingen, Germany
| | - H M Horlings
- Department of Pathology of Antoni van Leeuwenhoek, Netherlands Cancer Institute, Plesmanlaan 121, CX Amsterdam, The Netherlands
| | - P J Yong
- Department of Obstetrics and Gynaecology, University of British Columbia, Suite 930, 1125 Howe Street, Vancouver, British Columbia, Canada.,BC Women's Centre for Pelvic Pain & Endometriosis, BC Women's Hospital and Health Centre, Women' Health Centre, F2-4500 Oak St, Vancouver, British Columbia, Canada
| | - D G Huntsman
- Department of Molecular Oncology, BC Cancer Research Centre, Room 3-218, 675 West 10th Ave, Vancouver, British Columbia, Canada.,Department of Pathology and Laboratory Medicine, Rm G227, 2211 Wesbrook Mall, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Anatomical Pathology, Vancouver General Hospital, 899 W 12th Ave, Vancouver, British Columbia, Canada.,Department of Obstetrics and Gynaecology, University of British Columbia, Suite 930, 1125 Howe Street, Vancouver, British Columbia, Canada
| | - M S Anglesio
- Department of Molecular Oncology, BC Cancer Research Centre, Room 3-218, 675 West 10th Ave, Vancouver, British Columbia, Canada.,Department of Pathology and Laboratory Medicine, Rm G227, 2211 Wesbrook Mall, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Obstetrics and Gynaecology, University of British Columbia, Suite 930, 1125 Howe Street, Vancouver, British Columbia, Canada
| |
Collapse
|
5
|
Lac V, Praetorius TH, Verhoef L, Aguirre-Hernandez R, Nazeran TM, Tessier-Cloutier B, Orr N, Noga H, Khattra J, Koebel M, Horlings HM, Kommoss F, Brucker SY, Pasternak J, Yong PJ, Huntsman DG, Kommoss S, Anglesio MS, Krämer B. Iatrogenic endometriosis harbors somatic cancer-driver mutations. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- V Lac
- British Columbia Cancer Agency, Department of Molecular Oncology, Vancouver, Kanada
- University of British Columbia, Department of Pathology and Laboratory Medicine, Vancouver, Kanada
| | - TH Praetorius
- Universitätsklinikum Tübingen, Department für Frauengesundheit, Tübingen, Deutschland
- University of British Columbia, Department of Obstetrics and Gynecology, Vancouver, Kanada
| | - L Verhoef
- Netherlands Cancer Institute, Amsterdam, Niederlande
| | | | - TM Nazeran
- British Columbia Cancer Agency, Department of Molecular Oncology, Vancouver, Kanada
- University of British Columbia, Department of Pathology and Laboratory Medicine, Vancouver, Kanada
| | - B Tessier-Cloutier
- University of British Columbia, Department of Pathology and Laboratory Medicine, Vancouver, Kanada
- Vancouver General Hospital, Department of Anatomical Pathology, Vancouver, Kanada
| | - N Orr
- University of British Columbia, Department of Obstetrics and Gynecology, Vancouver, Kanada
| | - H Noga
- University of British Columbia, Department of Obstetrics and Gynecology, Vancouver, Kanada
- British Columbia Women's Hospital and Health Centre, BC Women's Centre for Pelvic Pain & Endometriosis, Vancouver, Kanada
| | - J Khattra
- Contextual Genomics, Vancouver, Kanada
| | - M Koebel
- University of Calgary, Department of Pathology and Laboratory Medicine, Calgary, Kanada
| | - HM Horlings
- Netherlands Cancer Institute, Amsterdam, Niederlande
| | - F Kommoss
- Medizin Campus Bodensee, Institut für Pathologie, Friedrichshafen, Deutschland
| | - SY Brucker
- Universitätsklinikum Tübingen, Department für Frauengesundheit, Tübingen, Deutschland
| | - J Pasternak
- Universitätsklinikum Tübingen, Department für Frauengesundheit, Tübingen, Deutschland
| | - PJ Yong
- University of British Columbia, Department of Obstetrics and Gynecology, Vancouver, Kanada
- British Columbia Women's Hospital and Health Centre, BC Women's Centre for Pelvic Pain & Endometriosis, Vancouver, Kanada
| | - DG Huntsman
- British Columbia Cancer Agency, Department of Molecular Oncology, Vancouver, Kanada
- University of British Columbia, Department of Pathology and Laboratory Medicine, Vancouver, Kanada
- Contextual Genomics, Vancouver, Kanada
| | - S Kommoss
- Universitätsklinikum Tübingen, Department für Frauengesundheit, Tübingen, Deutschland
| | - MS Anglesio
- University of British Columbia, Department of Pathology and Laboratory Medicine, Vancouver, Kanada
- University of British Columbia, Department of Obstetrics and Gynecology, Vancouver, Kanada
| | - B Krämer
- Universitätsklinikum Tübingen, Department für Frauengesundheit, Tübingen, Deutschland
| |
Collapse
|
6
|
Nijeboer F, Snyers A, Verhoef L, Branje T, Van Leeuwen R. EP-1847: Inter-fraction motion of the uterine cervix during EBRT measured using CBCT and polymer markers. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)32282-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
7
|
Severi E, Verhoef L, Thornton L, Guzman-Herrador BR, Faber M, Sundqvist L, Rimhanen-Finne R, Roque-Afonso AM, Ngui SL, Allerberger F, Baumann-Popczyk A, Muller L, Parmakova K, Alfonsi V, Tavoschi L, Vennema H, Fitzgerald M, Myrmel M, Gertler M, Ederth J, Kontio M, Vanbockstael C, Mandal S, Sadkowska-Todys M, Tosti ME, Schimmer B, O Gorman J, Stene-Johansen K, Wenzel JJ, Jones G, Balogun K, Ciccaglione AR, O' Connor L, Vold L, Takkinen J, Rizzo C. Large and prolonged food-borne multistate hepatitis A outbreak in Europe associated with consumption of frozen berries, 2013 to 2014. ACTA ACUST UNITED AC 2015; 20:21192. [PMID: 26227370 DOI: 10.2807/1560-7917.es2015.20.29.21192] [Citation(s) in RCA: 89] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
In May 2013, Italy declared a national outbreak of hepatitis A, which also affected several foreign tourists who had recently visited the country. Molecular investigations identified some cases as infected with an identical strain of hepatitis A virus subgenotype IA. After additional European Union/European Economic Area (EU/EEA) countries reported locally acquired and travel-related cases associated with the same outbreak, an international outbreak investigation team was convened, a European outbreak case definition was issued and harmonisation of the national epidemiological and microbiological investigations was encouraged. From January 2013 to August 2014, 1,589 hepatitis A cases were reported associated with the multistate outbreak; 1,102 (70%) of the cases were hospitalised for a median time of six days; two related deaths were reported. Epidemiological and microbiological investigations implicated mixed frozen berries as the vehicle of infection of the outbreak. In order to control the spread of the outbreak, suspected or contaminated food batches were recalled, the public was recommended to heat-treat berries, and post-exposure prophylaxis of contacts was performed. The outbreak highlighted how large food-borne hepatitis A outbreaks may affect the increasingly susceptible EU/EEA general population and how, with the growing international food trade, frozen berries are a potential high-risk food.
Collapse
Affiliation(s)
- E Severi
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
8
|
Verhoef L, van der Lubben M, Driesen C, Haenen A, Natsch S, Stobberingh E, de Greeff S. Antibiotic resistance in nursing homes, a real threat? Eur J Public Health 2014. [DOI: 10.1093/eurpub/cku166.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
9
|
MacDonald E, Steens A, Stene-Johansen K, Gillesberg Lassen S, Midgley SE, Lawrence J, Crofts J, Ngui SL, Balogun K, Frank C, Faber M, Gertler M, Verhoef L, Koopmans M, Sane J, van Pelt W, Sundqvist L, Vold L. Increase in hepatitis A in tourists from Denmark, England, Germany, the Netherlands, Norway and Sweden returning from Egypt, November 2012 to March 2013. Euro Surveill 2013. [DOI: 10.2807/ese.18.17.20468-en] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Since November 2012, there has been an increase in reported cases of hepatitis A in tourists returning from Egypt in several European countries. As of 24 April, 80 HAV cases in travellers with symptom onset after 1 November 2012 visiting different areas in Egypt have been reported. Four cases from Norway, six cases from the Netherlands and five cases from England share an identical hepatitis A viral RNA sequence. This increase in cases suggests that vaccination recommendations for travellers to hepatitis A endemic countries should be reinforced.
Collapse
Affiliation(s)
- E MacDonald
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
- Norwegian Institute of Public Health, Oslo, Norway
| | - A Steens
- Norwegian Institute of Public Health, Oslo, Norway
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | | | - S Gillesberg Lassen
- Department of Infectious Disease Epidemiology, Statens Serum Institut, Copenhagen, Denmark
| | - S E Midgley
- Department of Microbiological Diagnostics and Virology, Statens Serum Institut, Copenhagen, Denmark
| | | | - J Crofts
- Public Health England, London, England
| | - S L Ngui
- Public Health England, London, England
| | - K Balogun
- Public Health England, London, England
| | - C Frank
- Robert Koch Institute, Berlin, Germany
| | - M Faber
- Robert Koch Institute, Berlin, Germany
| | - M Gertler
- Postgraduate Training for Applied Epidemiology, Germany
- Robert Koch Institute, Berlin, Germany
| | - L Verhoef
- National Institute for Public Health and the Environment (RIVM), Netherlands
| | - M Koopmans
- National Institute for Public Health and the Environment (RIVM), Netherlands
| | - J Sane
- National Institute for Public Health and the Environment (RIVM), Netherlands
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - W van Pelt
- National Institute for Public Health and the Environment (RIVM), Netherlands
| | - L Sundqvist
- Swedish Institute for Communicable Disease Control, Stockholm, Sweden
| | - L Vold
- Norwegian Institute of Public Health, Oslo, Norway
| |
Collapse
|
10
|
MacDonald E, Steens A, Stene-Johansen K, Gillesberg Lassen S, Midgley S, Lawrence J, Crofts J, Ngui SL, Balogun K, Frank C, Faber M, Gertler M, Verhoef L, Koopmans M, Sane J, van Pelt W, Sundqvist L, Vold L. Increase in hepatitis A in tourists from Denmark, England, Germany, the Netherlands, Norway and Sweden returning from Egypt, November 2012 to March 2013. Euro Surveill 2013; 18:20468. [PMID: 23647624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Affiliation(s)
- E MacDonald
- Norwegian Institute of Public Health, Oslo, Norway.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
11
|
Niesters HG, Rossen JW, van der Avoort H, Baas D, Benschop K, Claas EC, Kroneman A, van Maarseveen N, Pas S, van Pelt W, Rahamat-Langendoen JC, Schuurman R, Vennema H, Verhoef L, Wolthers K, Koopmans M. Laboratory-based surveillance in the molecular era: the TYPENED model, a joint data-sharing platform for clinical and public health laboratories. ACTA ACUST UNITED AC 2013; 18:20387. [PMID: 23369392 DOI: 10.2807/ese.18.04.20387-en] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Laboratory-based surveillance, one of the pillars of monitoring infectious disease trends, relies on data produced in clinical and/or public health laboratories. Currently, diagnostic laboratories worldwide submit strains or samples to a relatively small number of reference laboratories for characterisation and typing. However, with the introduction of molecular diagnostic methods and sequencing in most of the larger diagnostic and university hospital centres in high-income countries, the distinction between diagnostic and reference/public health laboratory functions has become less clear-cut. Given these developments, new ways of networking and data sharing are needed. Assuming that clinical and public health laboratories may be able to use the same data for their own purposes when sequence-based testing and typing are used, we explored ways to develop a collaborative approach and a jointly owned database (TYPENED) in the Netherlands. The rationale was that sequence data - whether produced to support clinical care or for surveillance -can be aggregated to meet both needs. Here we describe the development of the TYPENED approach and supporting infrastructure, and the implementation of a pilot laboratory network sharing enterovirus sequences and metadata.
Collapse
Affiliation(s)
- H G Niesters
- Department of Medical Microbiology, Division of Clinical Virology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
12
|
Fournet N, Baas D, van Pelt W, Swaan C, Ober H, Isken L, Cremer J, Friesema I, Vennema H, Boxman I, Koopmans M, Verhoef L. Another possible food-borne outbreak of hepatitis A in the Netherlands indicated by two closely related molecular sequences, July to October 2011. Euro Surveill 2012; 17:20079. [PMID: 22340976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Affiliation(s)
- N Fournet
- Epidemiology and Surveillance Unit, Center for Infectious Diseases Control, National Institute for Public Health and the Environment (Rijksinstituut voor Volksgezondheid en Milieu, RIVM), Bilthoven, the Netherlands.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
13
|
Fournet N, Baas D, van Pelt W, Swaan C, Ober HJ, Isken L, Cremer J, Friesema I, Vennema H, Boxman I, Koopmans M, Verhoef L. Another possible food-borne outbreak of hepatitis A in the Netherlands indicated by two closely related molecular sequences, July to October 2011. Euro Surveill 2012. [DOI: 10.2807/ese.17.06.20079-en] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
In November 2011, a cluster of initially five cases of hepatitis A infection with closely related strains was identified in the Netherlands. England reported possibly related cases. Strains with identical sequences had been involved in previous outbreaks linked to semi-dried tomatoes. Investigation of the Dutch cluster suggested a link with ready-to-eat salads including those containing semi-dried tomatoes. Despite trace-back, a source was not identified. Vigilance is needed, and rapid sharing of data may help source-tracing.
Collapse
Affiliation(s)
- N Fournet
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
- Epidemiology and Surveillance Unit, Center for Infectious Diseases Control, National Institute for Public Health and the Environment (Rijksinstituut voor Volksgezondheid en Milieu, RIVM), Bilthoven, the Netherlands
| | - D Baas
- Laboratory for Infectious Diseases and Screening, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (Rijksinstituut voor Volksgezondheid en Milieu, RIVM), Bilthoven, the Netherlands
| | - W van Pelt
- Epidemiology and Surveillance Unit, Center for Infectious Diseases Control, National Institute for Public Health and the Environment (Rijksinstituut voor Volksgezondheid en Milieu, RIVM), Bilthoven, the Netherlands
| | - C Swaan
- Preparedness and Response Unit, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (Rijksinstituut voor Volksgezondheid en Milieu, RIVM), Bilthoven, the Netherlands
| | - H J Ober
- Food and Consumer Product Safety Authority (Nederlandse Voedsel en Waren Autoriteit), Utrecht, the Netherlands
| | - L Isken
- Preparedness and Response Unit, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (Rijksinstituut voor Volksgezondheid en Milieu, RIVM), Bilthoven, the Netherlands
| | - J Cremer
- Laboratory for Infectious Diseases and Screening, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (Rijksinstituut voor Volksgezondheid en Milieu, RIVM), Bilthoven, the Netherlands
| | - I Friesema
- Epidemiology and Surveillance Unit, Center for Infectious Diseases Control, National Institute for Public Health and the Environment (Rijksinstituut voor Volksgezondheid en Milieu, RIVM), Bilthoven, the Netherlands
| | - H Vennema
- Laboratory for Infectious Diseases and Screening, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (Rijksinstituut voor Volksgezondheid en Milieu, RIVM), Bilthoven, the Netherlands
| | - I Boxman
- Food and Consumer Product Safety Authority (Nederlandse Voedsel en Waren Autoriteit), Utrecht, the Netherlands
| | - M Koopmans
- Laboratory for Infectious Diseases and Screening, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (Rijksinstituut voor Volksgezondheid en Milieu, RIVM), Bilthoven, the Netherlands
| | - L Verhoef
- Laboratory for Infectious Diseases and Screening, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (Rijksinstituut voor Volksgezondheid en Milieu, RIVM), Bilthoven, the Netherlands
| |
Collapse
|
14
|
Visser H, Verhoef L, Schop W, Gotz HM. Outbreak investigation in two groups of coach passengers with gastroenteritis returning from Germany to the Netherlands in February 2009. Euro Surveill 2010. [DOI: 10.2807/ese.15.28.19615-en] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Binary file ES_Abstracts_Final_ECDC.txt matches
Collapse
Affiliation(s)
- H Visser
- Municipal Public Health Service Rotterdam-Rijnmond, Department Infectious Disease Control, Rotterdam, the Netherlands
| | - L Verhoef
- National Institute for Public Health and the Environment (RIVM), Diagnostic Laboratory for Infectious Diseases, Bilthoven, the Netherlands
| | - W Schop
- Municipal Public Health Service Rotterdam-Rijnmond, Department Infectious Disease Control, Rotterdam, the Netherlands
| | - H M Gotz
- Municipal Public Health Service Rotterdam-Rijnmond, Department Infectious Disease Control, Rotterdam, the Netherlands
| |
Collapse
|
15
|
Visser H, Verhoef L, Schop W, Götz HM. Outbreak investigation in two groups of coach passengers with gastroenteritis returning from Germany to the Netherlands in February 2009. Euro Surveill 2010; 15:19615. [PMID: 20650052] [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: 05/29/2023] Open
Abstract
In February 2009, an outbreak of 38 cases of gastroenteritis occurred among the participants of two Dutch coach trips (A and B) who visited the same hotel in Germany. We initiated an outbreak investigation to determine possible risk of food-borne infection. A retrospective cohort study was performed among 87 passengers using a self-administered questionnaire. The response rate was 75 of 87 (86%). Mean age was 65 years. Cases were defined as participants of the two coach trips who had diarrhoea and/or vomiting at least once within 24 hours in the period between 7 and 14 February 2009. We distinguished early and late cases, with symptoms starting within or after 72 hours of arrival in the hotel. Overall attack-rate was 38 of 75 (51%). Microbiological investigation was performed on stool samples of two passengers from Coach A and two passengers from Coach B. Identical norovirus genotype II.4 sequences were detected in all four samples. Univariate analysis revealed a potential risk for early cases from juice consumption , which was most clearly seen for Coach B on day of arrival (juice at lunch: relative risk (RR): 3.9, 95% confidence interval (CI): 1.3-11.7; juice at dinner: RR: 5.5, 95% CI: 1.6-18.1). A dose-response relationship was found. This outbreak was probably caused by using the taps of juice served in large containers with a tap for self-service, due to environmental contamination through person-to-person transmission. Still the role of either contaminated juice or contact with contaminated juice cannot be ruled out.
Collapse
Affiliation(s)
- H Visser
- Municipal Public Health Service Rotterdam-Rijnmond, Department Infectious Disease Control, Rotterdam, the Netherlands.
| | | | | | | |
Collapse
|
16
|
Petrignani M, Harms M, Verhoef L, van Hunen R, Swaan C, van Steenbergen J, Boxman I, Peran I Sala R, Ober H, Vennema H, Koopmans M, van Pelt W. Update: a food-borne outbreak of hepatitis A in the Netherlands related to semi-dried tomatoes in oil, January-February 2010. Euro Surveill 2010; 15:19572. [PMID: 20504389] [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: 05/29/2023] Open
Abstract
Between 31 December 2009 and 10 February 2010, 13 patients were infected by an identical hepatitis A virus strain not previously detected in the Netherlands. They had not been abroad and were widely distributed over the Netherlands. A case-control study including 12 cases and 44 controls identified semi-dried tomatoes in oil as the source of the outbreak (odds ratio: 20.0; 95% confidence interval: 1.5-274). The virus was not detected in any of 81 tested food samples. International trace-back is still ongoing.
Collapse
Affiliation(s)
- M Petrignani
- Department of Infectious Disease Control, Municipal Health Service (GGD Zuid-Holland West), Zoetermeer, the Netherlands.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
17
|
Petrignani M, Harms M, Verhoef L, van Hunen R, Swaan C, van Steenbergen J, Boxman I, Peran i Sala R, Ober HJ, Vennema H, Koopmans M, van Pelt W. Update: A food-borne outbreak of hepatitis A in the Netherlands related to semi-dried tomatoes in oil, January-February 2010. Euro Surveill 2010. [DOI: 10.2807/ese.15.20.19572-en] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Between 31 December 2009 and 10 February 2010, 13 patients were infected by an identical hepatitis A virus strain not previously detected in the Netherlands. They had not been abroad and were widely distributed over the Netherlands. A case-control study including 12 cases and 44 controls identified semi-dried tomatoes in oil as the source of the outbreak (odds ratio: 20.0; 95% confidence interval: 1.5-274). The virus was not detected in any of 81 tested food samples. International trace-back is still ongoing.
Collapse
Affiliation(s)
- M Petrignani
- Department of Infectious Disease Control, Municipal Health Service (GGD Zuid-Holland West), Zoetermeer, the Netherlands
| | - M Harms
- Epidemiology and Surveillance Unit, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (Rijksinstituut voor Volksgezondheid en Milieu, RIVM), Bilthoven, the Netherlands
| | - L Verhoef
- Laboratory for Infectious Diseases and Screening, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (Rijksinstituut voor Volksgezondheid en Milieu, RIVM), Bilthoven, the Netherlands
| | - R van Hunen
- Department of Infectious Disease Control, Municipal Health Service (GGD Zuid-Holland West), Zoetermeer, the Netherlands
| | - C Swaan
- Preparedness and Response Unit, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (Rijksinstituut voor Volksgezondheid en Milieu, RIVM), Bilthoven, the Netherlands
| | - J van Steenbergen
- Preparedness and Response Unit, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (Rijksinstituut voor Volksgezondheid en Milieu, RIVM), Bilthoven, the Netherlands
| | - I Boxman
- Food and Consumer Product Safety Authority (Voedsel en Waren Autoriteit), Zutphen, the Netherlands
| | - R Peran i Sala
- Food and Consumer Product Safety Authority (Voedsel en Waren Autoriteit), the Hague, the Netherlands
| | - H J Ober
- Food and Consumer Product Safety Authority (Voedsel en Waren Autoriteit), Amsterdam, the Netherlands
| | - H Vennema
- Laboratory for Infectious Diseases and Screening, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (Rijksinstituut voor Volksgezondheid en Milieu, RIVM), Bilthoven, the Netherlands
| | - M Koopmans
- Laboratory for Infectious Diseases and Screening, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (Rijksinstituut voor Volksgezondheid en Milieu, RIVM), Bilthoven, the Netherlands
| | - W van Pelt
- Epidemiology and Surveillance Unit, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (Rijksinstituut voor Volksgezondheid en Milieu, RIVM), Bilthoven, the Netherlands
| |
Collapse
|
18
|
Petrignani M, Verhoef L, van Hunen R, Swaan C, van Steenbergen J, Boxman I, Ober HJ, Vennema H, Koopmans M. A possible foodborne outbreak of hepatitis A in the Netherlands, January-February 2010. Euro Surveill 2010; 15:19512. [PMID: 20338146] [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: 05/29/2023] Open
Abstract
As of 1 March 2010, a total of 11 primary cases with onset of symptoms between 31 December 2009 and 10 February 2010, have been identified with identical hepatitis A genotype IB strains in the Netherlands. A relation with Australian and French foodborne outbreaks occurring in 2009 and 2010 is suspected. Ten of the 11 primary cases indicated that they had consumed one or more products containing semi-dried tomatoes during their incubation period.
Collapse
Affiliation(s)
- M Petrignani
- Department of Infectious Disease Control, Public Health Service, Zoetermeer, the Netherlands.
| | | | | | | | | | | | | | | | | |
Collapse
|
19
|
Petrignani M, Verhoef L, van Hunen R, Swaan C, van Steenbergen J, Boxman I, Ober HJ, Vennema H, Koopmans M. A possible foodborne outbreak of hepatitis A in the Netherlands, January-February 2010. Euro Surveill 2010. [DOI: 10.2807/ese.15.11.19512-en] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
As of 1 March 2010, a total of 11 primary cases with onset of symptoms between 31 December 2009 and 10 February 2010, have been identified with identical hepatitis A genotype IB strains in the Netherlands. A relation with Australian and French foodborne outbreaks occurring in 2009 and 2010 is suspected. Ten of the 11 primary cases indicated that they had consumed one or more products containing semi-dried tomatoes during their incubation period.
Collapse
Affiliation(s)
- M Petrignani
- Department of Infectious Disease Control, Public Health Service, Zoetermeer, the Netherlands
| | - L Verhoef
- Laboratory for Infectious Diseases and Screening, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (Rijksinstituut voor Volksgezondheid en Milieu , RIVM), Bilthoven, the Netherlands
| | - R van Hunen
- Department of Infectious Disease Control, Public Health Service, Zoetermeer, the Netherlands
| | - C Swaan
- Preparedness and Response Unit, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (Rijksinstituut voor Volksgezondheid en Milieu , RIVM), Bilthoven, the Netherlands
| | - J van Steenbergen
- Preparedness and Response Unit, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (Rijksinstituut voor Volksgezondheid en Milieu , RIVM), Bilthoven, the Netherlands
| | - I Boxman
- Food and Consumer Product Safety Authority, Zutphen, The Netherlands
| | - H J Ober
- Food and Consumer Product Safety Authority, Amsterdam, the Netherlands
| | - H Vennema
- Laboratory for Infectious Diseases and Screening, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (Rijksinstituut voor Volksgezondheid en Milieu , RIVM), Bilthoven, the Netherlands
| | - M Koopmans
- Laboratory for Infectious Diseases and Screening, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (Rijksinstituut voor Volksgezondheid en Milieu , RIVM), Bilthoven, the Netherlands
| |
Collapse
|
20
|
Bauer MP, Veenendaal D, Verhoef L, Bloembergen P, van Dissel JT, Kuijper EJ. Clinical and microbiological characteristics of community-onset Clostridium difficile infection in The Netherlands. Clin Microbiol Infect 2009; 15:1087-92. [PMID: 19624512 DOI: 10.1111/j.1469-0691.2009.02853.x] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
To elucidate the prevalence, characteristics and risk factors of community-onset Clostridium difficile infection (CO-CDI), an uncontrolled prospective study was performed. For 3 months in 2007-2008, three laboratories in The Netherlands tested all unformed stool samples submitted by general practitioners (GPs) for C. difficile by enzyme immunoassay for toxins A and B, irrespective of whether GPs specifically requested this. Patients with positive results were asked to complete a questionnaire. Positive stool samples were cultured for C. difficile, and isolates were characterized. In all, 2443 stool samples from 2423 patients were tested, and 37 patients (1.5%) with positive toxin test results were identified. Mixed infections were not found. Age varied from 1 to 92 years, and 18% were under the age of 20 years. Diarrhoea was typically frequent and watery, sometimes with admixture of blood or fever. Eight of 28 patients (29%) suffered recurrences. Among 31 patients with toxin-positive stool samples for whom information was available, 20 (65%) had not been admitted to a healthcare institution in the year before, 13 (42%) had not used antibiotics during the 6 months before, and eight (26%) had neither risk factor. A separate analysis for patients whose samples were both toxin-positive and culture-positive produced similar results. Cultured C. difficile isolates belonged to 13 different PCR ribotypes, and 24% of the isolates were non-typeable (rare or new) PCR ribotypes. In conclusion, CO-CDI can affect all age groups, and many patients do not have known risk factors. Several PCR ribotypes not encountered in hospital-associated outbreaks were found, suggesting the absence of a direct link between outbreaks and community-onset cases.
Collapse
Affiliation(s)
- M P Bauer
- Department of Infectious Diseases, Leiden University Medical Centre, Leiden, The Netherlands.
| | | | | | | | | | | |
Collapse
|
21
|
Verhoef L, Duizer E, Vennema H, Siebenga J, Swaan C, Isken L, Koopmans M, Balay K, Pothier P, McKeown P, van Dijk G, Capdepon P, Delmas G. Import of norovirus infections in the Netherlands and Ireland following pilgrimages to Lourdes, 2008--preliminary report. Euro Surveill 2008; 13:pii: 19025. [PMID: 19000561] [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: 05/27/2023] Open
Abstract
Between mid-September and 19 October 2008, nine clusters of norovirus infection involving around 90 primary cases and over a hundred secondary cases were identified in patients from the Netherlands, Ireland, Italy and France, linked to pilgrimage to Lourdes, France.
Collapse
Affiliation(s)
- L Verhoef
- National Institute for Public Health and the Environment, Center for Infectious Disease Control, Bilthoven, the Netherlands.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
22
|
Verhoef L, Duizer E, Vennema H, Siebenga J, Swaan C, Isken L, Koopmans M, Balay K, Pothier P, McKeown P, van Dijk G, Capdepon P, Delmas G. Import of norovirus infections in the Netherlands and Ireland following pilgrimages to Lourdes, 2008 – preliminary report. Euro Surveill 2008. [DOI: 10.2807/ese.13.44.19025-en] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Between mid-September and 19 October 2008, nine clusters of norovirus infection involving around 90 primary cases and over a hundred secondary cases were identified in patients from the Netherlands, Ireland, Italy and France, linked to pilgrimage to Lourdes, France.
Collapse
Affiliation(s)
- L Verhoef
- National Institute for Public Health and the Environment, Center for Infectious Disease Control, Bilthoven, the Netherlands
| | - E Duizer
- National Institute for Public Health and the Environment, Center for Infectious Disease Control, Bilthoven, the Netherlands
| | - H Vennema
- National Institute for Public Health and the Environment, Center for Infectious Disease Control, Bilthoven, the Netherlands
| | - J Siebenga
- National Institute for Public Health and the Environment, Center for Infectious Disease Control, Bilthoven, the Netherlands
| | - C Swaan
- National Institute for Public Health and the Environment, Center for Infectious Disease Control, Bilthoven, the Netherlands
| | - L Isken
- National Institute for Public Health and the Environment, Center for Infectious Disease Control, Bilthoven, the Netherlands
| | - M Koopmans
- National Institute for Public Health and the Environment, Center for Infectious Disease Control, Bilthoven, the Netherlands
| | - K Balay
- National Reference Centre for Enteric Viruses, Dijon, France
| | - P Pothier
- National Reference Centre for Enteric Viruses, Dijon, France
| | - P McKeown
- Health Protection Surveillance Centre, Dublin, Ireland
| | - G van Dijk
- Municipal Health Service West-Brabant, Breda, the Netherlands
| | - P Capdepon
- Direction Départementale des Affaires Sanitaires et Sociales (District Health and Social Services, DDASS) des Haute Pyrénées, France
| | - G Delmas
- Institut de Veille Sanitaire (French Institute for Public Health Surveillance, INVS), Saint Maurice, France
| |
Collapse
|
23
|
Verhoef L, Boxman IL, Duizer E, Rutjes SA, Vennema H, Friesema IHM, de Roda Husman AM, Koopmans M. Multiple exposures during a norovirus outbreak on a river-cruise sailing through Europe, 2006. Euro Surveill 2008; 13:18899. [PMID: 18761943] [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: 05/26/2023] Open
Abstract
In the summer of 2006, several cruise-related viral gastroenteritis outbreaks were reported in Europe. One report came from a river-cruise, belonging to a ship-owner who had two other ships with outbreaks. This situation warranted onsite investigation in order to identify a potential common source of infection. A retrospective cohort study was performed among 137 people on board. Epidemiological questionnaire data were analysed using logistic regression. Stool, food, water and surface samples were collected for norovirus detection. Norovirus GGII.4-2006b was responsible for 48 gastroenteritis cases on this ship as confirmed in six patients. Identical norovirus sequences were detected in stool samples, on surfaces and in tap water. Epidemiological and microbiological data indicated multiple exposures contributing to the outbreak. Microbiological results demonstrated person-to-person transmission to be clearly present. Epidemiological results indicated that consuming tap water was a risk factor; however, this could not be concluded definitively on the basis of the available data. A common source for all cruise-related outbreaks was unlikely. The ongoing outbreaks on this ship demonstrated that evidence based guidelines on effective disinfection strategies are needed.
Collapse
Affiliation(s)
- L Verhoef
- National institute for Public Health and the Environment, Center for Infectious Disease Control, Diagnostic Laboratory for Infectious Diseases, Bilthoven, the Netherlands.
| | | | | | | | | | | | | | | |
Collapse
|
24
|
Verhoef L, Boxman IL, Duizer E, Rutjes SA, Vennema H, Friesema IH, de Roda Husman AM, Koopmans M. Multiple exposures during a norovirus outbreak on a river-cruise sailing through Europe, 2006. Euro Surveill 2008. [DOI: 10.2807/ese.13.24.18899-en] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
In the summer of 2006, several cruise-related viral gastroenteritis outbreaks were reported in Europe. One report came from a river-cruise, belonging to a ship-owner who had two other ships with outbreaks. This situation warranted onsite investigation in order to identify a potential common source of infection. A retrospective cohort study was performed among 137 people on board. Epidemiological questionnaire data were analysed using logistic regression. Stool, food, water and surface samples were collected for norovirus detection. Norovirus GGII.4-2006b was responsible for 48 gastroenteritis cases on this ship as confirmed in six patients. Identical norovirus sequences were detected in stool samples, on surfaces and in tap water. Epidemiological and microbiological data indicated multiple exposures contributing to the outbreak. Microbiological results demonstrated person-to-person transmission to be clearly present. Epidemiological results indicated that consuming tap water was a risk factor; however, this could not be concluded definitively on the basis of the available data. A common source for all cruise-related outbreaks was unlikely. The ongoing outbreaks on this ship demonstrated that evidence based guidelines on effective disinfection strategies are needed.
Collapse
Affiliation(s)
- L Verhoef
- National institute for Public Health and the Environment, Center for Infectious Disease Control, Diagnostic Laboratory for Infectious Diseases, Bilthoven, the Netherlands
| | - IL Boxman
- Food and Consumer Product Safety Authority, Zutphen, The Netherlands
| | - E Duizer
- National institute for Public Health and the Environment, Center for Infectious Disease Control, Diagnostic Laboratory for Infectious Diseases, Bilthoven, the Netherlands
| | - S A Rutjes
- National institute for Public Health and the Environment, Center for Infectious Disease Control, Laboratory for Zoonoses and Environmental Microbiology, Bilthoven, the Netherlands
| | - H Vennema
- National institute for Public Health and the Environment, Center for Infectious Disease Control, Diagnostic Laboratory for Infectious Diseases, Bilthoven, the Netherlands
| | - I H Friesema
- National institute for Public Health and the Environment, Center for Infectious Disease Control, Epidemiology and Surveillance Unit, Bilthoven, the Netherlands
| | - A M de Roda Husman
- National institute for Public Health and the Environment, Center for Infectious Disease Control, Diagnostic Laboratory for Infectious Diseases, Bilthoven, the Netherlands
| | - M Koopmans
- National institute for Public Health and the Environment, Center for Infectious Disease Control, Diagnostic Laboratory for Infectious Diseases, Bilthoven, the Netherlands
| |
Collapse
|
25
|
Abstract
The FBVE (Food-borne Viruses in Europe) network was initiated during a research project funded by the European Commission (contract QLK1-1999-00594). The aim of the network is to establish a framework for rapid, (pre-publication) exchange of epidemiological, virological and molecular diagnostic data on outbreaks of viral gastroenteritis and acute hepatitis due to hepatitis A and E viruses for both surveillance and research purposes.
Collapse
Affiliation(s)
- E Duizer
- Laboratory for Infectious Diseases, Virology, Department, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - A Kroneman
- Laboratory for Infectious Diseases, Virology, Department, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - J Siebenga
- Laboratory for Infectious Diseases, Virology, Department, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - L Verhoef
- Laboratory for Infectious Diseases, Virology, Department, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - H Vennema
- Laboratory for Infectious Diseases, Virology, Department, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - M Koopmans
- Laboratory for Infectious Diseases, Virology, Department, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Collective the FBVE network
- Laboratory for Infectious Diseases, Virology, Department, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| |
Collapse
|
26
|
Duizer E, Kroneman A, Siebenga J, Verhoef L, Vennema H, Koopmans M. Typing database for noroviruses. Euro Surveill 2008; 13:18867. [PMID: 18761977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Affiliation(s)
- E Duizer
- Laboratory for Infectious Diseases, Virology, Department, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | | | | | | | | | | |
Collapse
|
27
|
Abstract
Abstract
The emergence of severe acute respiratory syndrome (SARS), Nipah virus and H5N1 has sparked fears of food-borne dissemination of viruses, resulting in an increased focus on microbiological food safety. Norovirus (NoV) and hepatitis A virus (HAV) have been recognized as priorities based on their illness burden, and as models for prevention studies. In addition, hepatitis E virus is considered an emerging food-borne pathogen. Systematic surveillance for food-borne viral diseases, where present, has to deal with underreporting, with available data biased towards developed countries, making true estimates of the burden of illness challenging. Nevertheless, food-borne viral outbreaks are often reported, whereas current measures undertaken by food safety management organizations are focused primarily on bacterial contamination and are insufficient for viruses in food. There has been a shift towards molecular techniques for the diagnosis and detection of viruses in food, but a definite link to food is still hard to establish owing to the low levels of viruses in foods. Moreover, multiple strains may be involved in sewage-contaminated foods, with the risk of recombination and development of novel strains after ingestion. To enable monitoring of food and food safety, sensitive routine methods are needed, and methods for detection of NoV and HAV in risk foods (shellfish, soft fruit and leafy greens) are currently validated. Norovirus cannot be cultured, but the murine NoV may be a surrogate for studying NoV survival. In all, significant progress has been made in understanding food-borne viral infections, but clear data gaps still exist and should be the focus of future research.
Collapse
|
28
|
Koopmans M, Harris J, Verhoef L, Depoortere E, Takkinen J, Coulombier D. European investigation into recent norovirus outbreaks on cruise ships: update. ACTA ACUST UNITED AC 2006; 11:E060706.5. [PMID: 16966757 DOI: 10.2807/esw.11.27.02997-en] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The European investigation into norovirus infection outbreaks on cruise ships,
Collapse
Affiliation(s)
- M Koopmans
- National Institute of Public Health (RIVM), Bilthoven,The Netherlands.
| | | | | | | | | | | |
Collapse
|
29
|
Lipman J, Gous AGS, Mathivha LR, Tshukutsoane S, Scribante J, Hon H, Pinder M, Riera-Fanego JF, Verhoef L, Stass H. Ciprofloxacin pharmacokinetic profiles in paediatric sepsis: how much ciprofloxacin is enough? Intensive Care Med 2002; 28:493-500. [PMID: 11967606 DOI: 10.1007/s00134-002-1212-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [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: 04/17/2001] [Accepted: 12/14/2001] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To determine the pharmacokinetic profile of ciprofloxacin 20 mg/kg per day (10 mg/kg administered intravenously 12 hourly) in paediatric patients with severe sepsis. DESIGN Open and prospective. SETTING Tertiary referral multi-disciplinary ICU. PATIENTS Twenty patients (two groups - group A: 3 months-1 year; group B 1-5 years). INTERVENTIONS Timed blood samples were taken for pharmacokinetics after the first dose (D(0)), as well as day 2 (D(2)) and then between days 6-8. MEASUREMENTS AND RESULTS Ciprofloxacin serum levels were measured by high performance liquid chromatography. Demographic and clinical data and all adverse events were noted. Standard pharmacokinetic variables were calculated by non-compartmental methods. Peak concentrations (C(max)) for group A were D(0) 6.1+/-1.2 mg/l, D(2) 9.0+/-1.8 mg/l and D(7) 5.8+/-1.3 mg/l and, for group B, 7.4+/-1.3 mg/l, 7.8+/-1.6 mg/l and 6.4+/-1.3 mg/l, respectively, for the study periods. Concentration 12 h after the start of infusion (C(min)) for all periods were 0.2 mg/l or less. Areas under the curve (AUC, 12 h) were group A: 15.6+/-1.3, 19.2+/-1.63 and 14.1+/-1.4 mg/h per l, and group B: 15.9+/-1.3, 18.0+/-1.7 and 13.2+/-1.26 mg/h per l. One patient presenting with seizures, initially controlled, had another convulsion and a further patient developed seizures whilst on ciprofloxacin. C(max) in these patients were higher than the average C(max). The convulsions of both patients were easily controlled. No other drug-related serious adverse events occurred. No arthropathy was noted. Three patients died of their underlying disease. CONCLUSIONS There was no accumulation of drug even after 7 days of administration. Our C(max) and AUC were lower than that achieved in a similar adult pharmacokinetic study. To achieve end points of area under the inhibitory curve (AUIC) of 100-150 mg/h per l, 10 mg/kg ciprofloxacin eight hourly would be required for some resistant ICU organisms.
Collapse
Affiliation(s)
- J Lipman
- Intensive Care Facility, Royal Brisbane Hospital, Anaesthesiology and Critical Care, University of Queensland, Herston Road, Herston 4029, Brisbane, Queensland, Australia.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
30
|
Hoeffken G, Meyer HP, Winter J, Verhoef L. The efficacy and safety of two oral moxifloxacin regimens compared to oral clarithromycin in the treatment of community-acquired pneumonia. Respir Med 2001; 95:553-64. [PMID: 11453311 DOI: 10.1053/rmed.2001.1113] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
An international multi-centre, randomized, prospective, double-blind study compared oral moxifloxacin (200 mg or 400 mg once daily for 10 days) with oral clarithromycin (500 mg, twice daily for 10 days) in the treatment of community-acquired pneumonia (CAP). The clinical success rate in the evaluable population at the primary efficacy assessment, 3-5 days after the end of study treatment, was 93.9% in patients treated with 200 mg moxifloxacin; 94.4%, with 400 mg moxifloxacin; and 94.3%, with clarithromycin. Clinical success rates were maintained at follow-up, 21-28 days after the end of treatment: 90.7% (200 mg moxifloxacin), 92.8% (400 mg moxifloxacin) and 92.2% (clarithromycin). The 95% confidence intervals indicated that all three treatment regimens were equally effective in treating CAP. At follow-up, the 400 mg moxifloxacin dose had a slightly higher observed cure rate than the 200 mg moxifloxacin dose, but this was not statistically significant. The most frequently isolated pathogens were Streptococcus pneumoniae (42%), Haemophilus influenzae (19%), Haemophilus parainfluenzae (10%), Moraxella catarrhalis (6%), Klebsiella pneumoniae (5%) and Staphylococcus aureus (4%). The bacteriological success rate (eradication and presumed eradication) was 72.5% (29/40) for 200 mg moxifloxacin, 78.7% (37/47) for 400 mg moxifloxacin and 70.7% (29/41) for clarithromycin. The adverse event profile was comparable between the three treatment groups. Most adverse events, possibly or probably related to the study drug, were generally mild or moderate in severity and mostly related to the digestive system: diarrhoea, nausea and abdominal pain in 200 mg moxifloxacin patients; diarrhoea, liver function abnormalities and nausea in 400 mg moxifloxacin patients and liver function abnormalities, diarrhoea, nausea and taste perversion in clarithromycin patients. Study drugs were discontinued because of adverse events in 7/229 (3%) patients treated with 200 mg moxifloxacin, 11/224 (5%) with moxifloxacin 400 mg and 11/222 (5%) with clarithromycin. In all assessments, moxifloxacin was at least as effective clinically, and as well tolerated as clarithromycin in the treatment of CAP. Bacteriological success rates in moxifloxacin-treated patients were greater than those of clarithromycin. Moxifloxacin, given once daily, is free of many drug-drug interactions and requires no dosage adjustments in most renal hepatic deficient patients.
Collapse
Affiliation(s)
- G Hoeffken
- University Clinic Carl Gustav Carus Medical Clinic/Pneumology, Dresden, Germany.
| | | | | | | |
Collapse
|
31
|
Omer RE, Verhoef L, Van't Veer P, Idris MO, Kadaru AM, Kampman E, Bunschoten A, Kok FJ. Peanut butter intake, GSTM1 genotype and hepatocellular carcinoma: a case-control study in Sudan. Cancer Causes Control 2001; 12:23-32. [PMID: 11227922 DOI: 10.1023/a:1008943200826] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.6] [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: 11/12/2022]
Abstract
OBJECTIVE Hepatocellular carcinoma (HCC) is one of the major cancers in the world. In Sudan the incidence is thought to be high and increasing. This study aims to assess the association between peanut butter intake, as a source of aflatoxins, and the GSTM1 genotype in the etiology of HCC. METHOD A case control study was conducted among 150 patients and 205 controls from two regions in Sudan. Food habits with special reference to peanut butter consumption, as well as peanut storage systems, have been investigated, as well as confounders such as hepatitis, drinking and smoking habits, and demographic characteristics. GSTM1 genotype was assessed in DNA extracted from blood samples (110 cases, 189 controls). RESULTS A positive association was observed for highest vs. lowest quartile of peanut butter intake, humid storage system and HCC, with ORs (95% CI) being 3.0 (1.6-5.5) and 1.6 (1.1-2.5) respectively. The positive association with peanut butter intake was essentially limited to subjects with GSTM1 null genotype with OR for highest vs. lowest quartile 16.7 (2.7-105). CONCLUSION Peanut butter consumption has been identified as a strong risk factor of HCC in a region with endemic aflatoxin contamination in Sudan and was essentially limited to subjects with the GSTM1 null genotype.
Collapse
Affiliation(s)
- R E Omer
- Department of Crop Protection, Faculty of Agriculture, University of Khartoum, Sudan.
| | | | | | | | | | | | | | | |
Collapse
|
32
|
Verhoef L, van der Kogel A. A patient who developed necrosis of the temporal lobe after irradiation of the parotid gland for pleomorphic adenoma. Int J Oral Maxillofac Surg 2000; 29:155. [PMID: 10833156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
|