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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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van Dorp SM, Hensgens MPM, Dekkers OM, Demeulemeester A, Buiting A, Bloembergen P, de Greeff SC, Kuijper EJ. Spatial clustering and livestock exposure as risk factor for community-acquired Clostridium difficile infection. Clin Microbiol Infect 2018; 25:607-612. [PMID: 30076972 DOI: 10.1016/j.cmi.2018.07.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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: 03/02/2018] [Revised: 06/17/2018] [Accepted: 07/18/2018] [Indexed: 12/17/2022]
Abstract
OBJECTIVES Clostridium difficile infections (CDI) account for 1.5% of diarrhoeic episodes in patients attending a general practitioner in the Netherlands, but its sources are unknown. We searched for community clusters to recognize localized point sources of CDI. METHODS Between October 2010 and February 2012, a community-based prospective nested case-control study was performed in three laboratories in the Netherlands with a study population of 2 810 830 people. Bernoulli spatial scan and space-time permutation models were used to detect spatial and/or temporal clusters of CDI. In addition, a multivariate conditional logistic regression model was constructed to test livestock exposure as a supposed risk factor in CDI patients without hospital admission within the previous 12 weeks (community-acquired (CA) CDI). RESULTS In laboratories A, B and C, 1.3%, 1.8% and 2.1% of patients with diarrhoea tested positive for CDI, respectively. The mean age of CA-CDI patients (n = 124) was 49 years (standard deviation, 22.6); 64.5% were female. No spatial or temporal clusters of CDI cases were detected compared to C. difficile-negative diarrhoeic controls. Except for one false-positive signal, no spatiotemporal interaction amongst CDI cases was found. Livestock exposure was not related to CA-CDI (odds ratio, 0.99; 95% confidence interval, 0.44-2.24). Ten percent of CA-CDIs was caused by PCR ribotype 078, spatially dispersed throughout the study area. CONCLUSIONS The absence of clusters of CDI cases in a community cohort of diarrhoeic patients suggests a lack of localized point sources of CDI in the living environment of these patients.
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Affiliation(s)
- S M van Dorp
- Department of Medical Microbiology, Leiden University Medical Center, Leiden, The Netherlands.
| | - M P M Hensgens
- Department of Internal Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
| | - O M Dekkers
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands; Department of Endocrinology and Metabolic Diseases, Leiden University Medical Center, Leiden, The Netherlands
| | - A Demeulemeester
- Center for Diagnostic Support in Primary Care (SHL-Groep), Etten-Leur, The Netherlands
| | - A Buiting
- Laboratory for Medical Microbiology and Immunology of the St Elisabeth Hospital, Tilburg, The Netherlands
| | - P Bloembergen
- Laboratory of Clinical Microbiology and Infectious Diseases, Isala klinieken, Zwolle, The Netherlands
| | - S C de Greeff
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - E J Kuijper
- Department of Medical Microbiology, Leiden University Medical Center, Leiden, The Netherlands
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Woolliams ER, Anhalt K, Ballico M, Bloembergen P, Bourson F, Briaudeau S, Campos J, Cox MG, del Campo D, Dong W, Dury MR, Gavrilov V, Grigoryeva I, Hernanz ML, Jahan F, Khlevnoy B, Khromchenko V, Lowe DH, Lu X, Machin G, Mantilla JM, Martin MJ, McEvoy HC, Rougié B, Sadli M, Salim SGR, Sasajima N, Taubert DR, Todd ADW, Van den Bossche R, van der Ham E, Wang T, Whittam A, Wilthan B, Woods DJ, Woodward JT, Yamada Y, Yamaguchi Y, Yoon HW, Yuan Z. Thermodynamic temperature assignment to the point of inflection of the melting curve of high-temperature fixed points. Philos Trans A Math Phys Eng Sci 2016; 374:20150044. [PMID: 26903099 DOI: 10.1098/rsta.2015.0044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/25/2015] [Indexed: 06/05/2023]
Abstract
The thermodynamic temperature of the point of inflection of the melting transition of Re-C, Pt-C and Co-C eutectics has been determined to be 2747.84 ± 0.35 K, 2011.43 ± 0.18 K and 1597.39 ± 0.13 K, respectively, and the thermodynamic temperature of the freezing transition of Cu has been determined to be 1357.80 ± 0.08 K, where the ± symbol represents 95% coverage. These results are the best consensus estimates obtained from measurements made using various spectroradiometric primary thermometry techniques by nine different national metrology institutes. The good agreement between the institutes suggests that spectroradiometric thermometry techniques are sufficiently mature (at least in those institutes) to allow the direct realization of thermodynamic temperature above 1234 K (rather than the use of a temperature scale) and that metal-carbon eutectics can be used as high-temperature fixed points for thermodynamic temperature dissemination. The results directly support the developing mise en pratique for the definition of the kelvin to include direct measurement of thermodynamic temperature.
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Affiliation(s)
- E R Woolliams
- National Physical Laboratory (NPL), Hampton Road, Teddington TW11 0LW, UK
| | - K Anhalt
- Physikalisch-Technische Bundesanstalt (PTB), Abbestrasse 2-12, Berlin 10587, Germany
| | - M Ballico
- Temperature Standards, National Measurement Institute Australia (NMIA), Bradfield Road, West Lindfield, New South Wales 2070, Australia
| | - P Bloembergen
- Research Institute for Physical Measurement, National Metrology Institute of Japan, National Institute of Advanced Industrial Science and Technology (AIST), 1-1-1 Umezono, Tsukuba, Ibaraki 305-8563, Japan Division of Thermophysics and Process Measurements, National Institute of Metrology (NIM), No. 18 Bei San Huan Dong Lu, Beijing 100029, People's Republic of China
| | - F Bourson
- High Temperature Metrology Department, Laboratoire commun de métrologie (LNE-Cnam), 61 rue du Landy, Saint Denis 93210, France
| | - S Briaudeau
- High Temperature Metrology Department, Laboratoire commun de métrologie (LNE-Cnam), 61 rue du Landy, Saint Denis 93210, France
| | - J Campos
- Optical Institute, Spanish National Research Council (CSIC), Serrano, 144, Madrid 28006, Spain
| | - M G Cox
- National Physical Laboratory (NPL), Hampton Road, Teddington TW11 0LW, UK
| | - D del Campo
- Centro Español de Metrologia, C/del Alfar, 2, Tres Cantos 28760, Spain
| | - W Dong
- Division of Thermophysics and Process Measurements, National Institute of Metrology (NIM), No. 18 Bei San Huan Dong Lu, Beijing 100029, People's Republic of China
| | - M R Dury
- National Physical Laboratory (NPL), Hampton Road, Teddington TW11 0LW, UK
| | - V Gavrilov
- All-Russian Research Institute for Optical and Physical Measurements (VNIIOFI), Ozernaya 46, Moscow 119361, Russia
| | - I Grigoryeva
- All-Russian Research Institute for Optical and Physical Measurements (VNIIOFI), Ozernaya 46, Moscow 119361, Russia
| | - M L Hernanz
- Optical Institute, Spanish National Research Council (CSIC), Serrano, 144, Madrid 28006, Spain
| | - F Jahan
- Temperature Standards, National Measurement Institute Australia (NMIA), Bradfield Road, West Lindfield, New South Wales 2070, Australia
| | - B Khlevnoy
- All-Russian Research Institute for Optical and Physical Measurements (VNIIOFI), Ozernaya 46, Moscow 119361, Russia
| | - V Khromchenko
- Sensor Science Division, National Institute of Standards and Technology, 100 Bureau Drive, Gaithersburg, MD 20899, USA
| | - D H Lowe
- National Physical Laboratory (NPL), Hampton Road, Teddington TW11 0LW, UK
| | - X Lu
- Division of Thermophysics and Process Measurements, National Institute of Metrology (NIM), No. 18 Bei San Huan Dong Lu, Beijing 100029, People's Republic of China
| | - G Machin
- National Physical Laboratory (NPL), Hampton Road, Teddington TW11 0LW, UK
| | - J M Mantilla
- Centro Español de Metrologia, C/del Alfar, 2, Tres Cantos 28760, Spain
| | - M J Martin
- Centro Español de Metrologia, C/del Alfar, 2, Tres Cantos 28760, Spain
| | - H C McEvoy
- National Physical Laboratory (NPL), Hampton Road, Teddington TW11 0LW, UK
| | - B Rougié
- High Temperature Metrology Department, Laboratoire commun de métrologie (LNE-Cnam), 61 rue du Landy, Saint Denis 93210, France
| | - M Sadli
- High Temperature Metrology Department, Laboratoire commun de métrologie (LNE-Cnam), 61 rue du Landy, Saint Denis 93210, France
| | - S G R Salim
- High Temperature Metrology Department, Laboratoire commun de métrologie (LNE-Cnam), 61 rue du Landy, Saint Denis 93210, France Radiometry and Photometry Division, National Institute of Standards (NIS), PO Box 136, President Sadat Street, El-Haram, Giza, Egypt
| | - N Sasajima
- Research Institute for Physical Measurement, National Metrology Institute of Japan, National Institute of Advanced Industrial Science and Technology (AIST), 1-1-1 Umezono, Tsukuba, Ibaraki 305-8563, Japan
| | - D R Taubert
- Physikalisch-Technische Bundesanstalt (PTB), Abbestrasse 2-12, Berlin 10587, Germany
| | - A D W Todd
- National Research Council Canada, 1200 Montreal Road, Ottawa, Ontario K1A 0R6, Canada
| | - R Van den Bossche
- National Physical Laboratory (NPL), Hampton Road, Teddington TW11 0LW, UK Department of Physics, University of Surrey, Guildford, Surrey GU2 7XH, UK
| | - E van der Ham
- Temperature Standards, National Measurement Institute Australia (NMIA), Bradfield Road, West Lindfield, New South Wales 2070, Australia
| | - T Wang
- Division of Thermophysics and Process Measurements, National Institute of Metrology (NIM), No. 18 Bei San Huan Dong Lu, Beijing 100029, People's Republic of China
| | - A Whittam
- National Physical Laboratory (NPL), Hampton Road, Teddington TW11 0LW, UK
| | - B Wilthan
- Physikalisch-Technische Bundesanstalt (PTB), Abbestrasse 2-12, Berlin 10587, Germany
| | - D J Woods
- National Research Council Canada, 1200 Montreal Road, Ottawa, Ontario K1A 0R6, Canada
| | - J T Woodward
- Sensor Science Division, National Institute of Standards and Technology, 100 Bureau Drive, Gaithersburg, MD 20899, USA
| | - Y Yamada
- Research Institute for Physical Measurement, National Metrology Institute of Japan, National Institute of Advanced Industrial Science and Technology (AIST), 1-1-1 Umezono, Tsukuba, Ibaraki 305-8563, Japan
| | - Y Yamaguchi
- Research Institute for Physical Measurement, National Metrology Institute of Japan, National Institute of Advanced Industrial Science and Technology (AIST), 1-1-1 Umezono, Tsukuba, Ibaraki 305-8563, Japan
| | - H W Yoon
- Sensor Science Division, National Institute of Standards and Technology, 100 Bureau Drive, Gaithersburg, MD 20899, USA
| | - Z Yuan
- Division of Thermophysics and Process Measurements, National Institute of Metrology (NIM), No. 18 Bei San Huan Dong Lu, Beijing 100029, People's Republic of China
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Meeuwes FO, Hukshorn CJ, Bloembergen P. Severe abdominal pain three weeks after a hemi-hepatectomy. Neth J Med 2015; 73:392-393. [PMID: 26478556] [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: 06/05/2023]
Affiliation(s)
- F O Meeuwes
- Departments of Internal Medicine, Intensive Care Medicine, Isala, Zwolle, the Netherlands
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Reusken C, Cleton N, Medonça Melo M, Visser C, GeurtsvanKessel C, Bloembergen P, Koopmans M, Schmidt-Chanasit J, van Genderen P. Ross River virus disease in two Dutch travellers returning from Australia, February to April 2015. Euro Surveill 2015; 20. [DOI: 10.2807/1560-7917.es2015.20.31.21200] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
We report two cases of Ross River virus (RRV) infection in Dutch travellers who visited Australia during February to April 2015. These cases coincided with the largest recorded outbreak of RRV disease in Australia since 1996. This report serves to create awareness among physicians to consider travel-related RRV disease in differential diagnosis of patients with fever, arthralgia and/or rash returning from the South Pacific area, and to promote awareness among professionals advising travellers to this region.
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Affiliation(s)
- C Reusken
- Department of Viroscience, WHO Collaborating Centre for Arbovirus and Haemorrhagic Fever Reference and Research, Erasmus MC, Rotterdam, the Netherlands
| | - N Cleton
- Department of Viroscience, WHO Collaborating Centre for Arbovirus and Haemorrhagic Fever Reference and Research, Erasmus MC, Rotterdam, the Netherlands
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - M Medonça Melo
- Institute for Tropical Diseases, Harbour Hospital, Rotterdam, the Netherlands
| | - C Visser
- General practice Havelte, Havelte, the Netherlands
| | - C GeurtsvanKessel
- Department of Viroscience, WHO Collaborating Centre for Arbovirus and Haemorrhagic Fever Reference and Research, Erasmus MC, Rotterdam, the Netherlands
| | - P Bloembergen
- Laboratory for Medical Microbiology and Infectious diseases, Isala Clinics, Zwolle, the Netherlands
| | - M Koopmans
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
- Department of Viroscience, WHO Collaborating Centre for Arbovirus and Haemorrhagic Fever Reference and Research, Erasmus MC, Rotterdam, the Netherlands
| | - J Schmidt-Chanasit
- German Centre for Infection Research (DZIF), Hamburg-Luebeck-Borstel, Hamburg, Germany
- Bernhard Nocht Institute for Tropical Medicine, WHO Collaborating Centre for Arbovirus and Haemorrhagic Fever Reference and Research, Hamburg, Germany
| | - P van Genderen
- Institute for Tropical Diseases, Harbour Hospital, Rotterdam, the Netherlands
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Hensgens M, Dekkers O, Demeulemeester A, Buiting A, Bloembergen P, van Benthem B, Le Cessie S, Kuijper E. Diarrhoea in general practice: when should a Clostridium difficile infection be considered? Results of a nested case-control study. Clin Microbiol Infect 2014; 20:O1067-74. [DOI: 10.1111/1469-0691.12758] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Revised: 05/22/2014] [Accepted: 07/02/2014] [Indexed: 12/01/2022]
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Bruins MJ, Verbeek E, Wallinga JA, Bruijnesteijn van Coppenraet LES, Kuijper EJ, Bloembergen P. Evaluation of three enzyme immunoassays and a loop-mediated isothermal amplification test for the laboratory diagnosis of Clostridium difficile infection. Eur J Clin Microbiol Infect Dis 2012; 31:3035-9. [PMID: 22706512 DOI: 10.1007/s10096-012-1658-y] [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] [Received: 03/13/2012] [Accepted: 05/15/2012] [Indexed: 02/07/2023]
Abstract
The laboratory diagnosis of Clostridium difficile infection (CDI) consists of the detection of toxigenic Clostridium difficile, and/or its toxins A or B in stool preferably in a two-step algorithm. In a prospective study, we compared the performance of three toxin enzyme immunoassays (EIAs)-ImmunoCard Toxins A & B, Premier Toxins A & B and C. diff Quik Chek Complete, which combines a toxins test and a glutamate dehydrogenase (GDH) antigen EIA in one device -and the loop-mediated isothermal amplification assay Illumigene C. difficile. In total 986 stool samples were analyzed. Compared with toxigenic culture as the gold standard, sensitivities, specificities, PPV and NPV values of the toxin EIAs were 41.1-54.8 %, 98.9-100 %, 75.0-100 % and 95.5-96.5 % respectively, of the Illumigene assay 93.3 %, 99.7 %, 95.8 % and 99.5 %. Illumigene assays performed significantly better for non-014/020 PCR-ribotypes than for C. difficile isolates belonging to 014/020. Discrepant analysis of three culture-negative, but Illumigene-positive samples, revealed the presence of toxin genes using real-time PCRs. In addition to the GDH EIA (NPV of 99.8 %), the performance of Illumigene allows this test to be introduced as a first screening test for CDI- or as a confirmation test for GDH -positive samples, although the initial invalid Illumigene result of 4.4 % is a point of concern.
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Affiliation(s)
- M J Bruins
- Laboratory of Clinical Microbiology and Infectious Diseases, Isala klinieken, Stilobadstraat 3, 8021AB, Zwolle, The Netherlands.
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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.
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Affiliation(s)
- M P Bauer
- Department of Infectious Diseases, Leiden University Medical Centre, Leiden, The Netherlands.
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Abstract
Schistosomiasis is the most frequently imported helminthic infection in The Netherlands. Patients with Schistosoma haematobium infections usually present with fever, hematuria, dysuria, or urinary frequency. The ectopic localizations in female genital schistosomiasis are frequently misdiagnosed or confounded with sexually transmitted diseases or genital tract cancers. This paper describes a patient who presented with vulvar hypertrophy as a symptom of acute female genital schistosomiasis. The aim of this paper is to draw attention to a neglected parasitic disease that in the future will be encountered in increasing numbers in Western Europe.
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Affiliation(s)
- J S Laven
- Department of Obstetrics and Gynaecology, University Hospital St Radboud, Nijmegen, The Netherlands
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Laheij RJ, Witteman EM, Bloembergen P, de Koning RW, Jansen JB, Verbeek AL. Short-term follow-up by serology of patients given antibiotic treatment for Helicobacter pylori infection. J Clin Microbiol 1998; 36:1193-6. [PMID: 9574675 PMCID: PMC104798 DOI: 10.1128/jcm.36.5.1193-1196.1998] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [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: 02/07/2023] Open
Abstract
Helicobacter pylori serology and in particular enzyme-linked immunosorbent assays for the measurement of immunoglobulin G (IgG) antibody titers form an accurate means of diagnosing H. pylori infection in patients before treatment. H. pylori serology is of limited value in monitoring treatment because of the slow decline in antibody titers. In the present study we aimed to measure the most suitable moment after antibiotic treatment at which serology should be used to monitor treatment. Sixty-four patients who had nonulcer dyspepsia and H. pylori infection and who underwent upper gastrointestinal endoscopy because of persistent dyspeptic symptoms were included in the study. H. pylori cure was confirmed by histology and culture 5 weeks after the completion of the antibiotic treatment. Serological examination was performed before therapy and at 5 weeks, 10 weeks, and 1 year after the completion of antibiotic treatment. Diagnostic performance was assessed by receiver-operating characteristic analysis. The areas under the receiver-operating characteristic curves of the H. pylori antibody titers at 5 weeks, 10 weeks, and 1 year after the completion of treatment were 0.53 (95% confidence interval [CI], 0.36 to 0.69), 0.60 (95% CI, 0.43 to 0.76), and 0.78 (95% CI, 0.63 to 0.93), respectively. The areas under the receiver-operating characteristic curves of the changes in H. pylori IgG antibody titers at 5 weeks, 10 weeks, and 1 year after the completion of treatment in comparison with the pretreatment titers were 0.85 (95% CI, 0.72 to 0.97), 0.96 (95% CI, 0.89 to 1.0), and 1.0 (95% CI, not estimable), respectively. We conclude that serology forms a useful means of monitoring treatment in patients with nonulcer dyspepsia and H. pylori infection as early as 10 weeks and maybe even sooner after the completion of treatment for the infection.
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Affiliation(s)
- R J Laheij
- Department of Gastroenterology, University Hospital Nijmegen, The Netherlands.
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Reijnierse JE, Dofferhoff AS, van Norel GJ, Bloembergen P. [Systemic fat necrosis and septic arthritis in acute pancreatitis]. Ned Tijdschr Geneeskd 1996; 140:31-4. [PMID: 8569908] [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: 01/31/2023]
Abstract
Systemic fatty necrosis secondary to acute pancreatitis was diagnosed in a 47-year-old man with high fever and painful nodules on the arms and the upper legs. This was complicated by fatal septic shock, septic arthritis and extensive soft tissue infections with Enterobacter cloacae, which was unsuccessfully treated with several antibiotic regimens, and from which the patient died.
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Affiliation(s)
- J E Reijnierse
- Afd. Interne Geneeskunde, Canisius-Wilhelmina Ziekenhuis, Nijmegen
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Abstract
Evidence is growing that autoimmune reactivity results from a combination of endogenous (e.g. MHC type) and environmental factors. Our experimental study focuses on the induction of autoimmune reactivity by microbial factors. Splenic formation and serum levels of anti-erythrocyte antibodies and circulating immune complexes were taken as parameters. It was found that experimental infection of mice with Escherichia coli and Salmonella typhimurium was accompanied by clear signs of autoimmune reactivity, smooth bacteria being almost ten times as potent as rough mutant strains. An attempt was made to correlate the data obtained with live bacteria to their corresponding endotoxins. It was concluded that the induction of more prominent autoimmune reactivity by smooth bacteria must be ascribed to a longer survival time in vivo. Our data support the view that bacterium-derived factors are involved in the etiology (and possibly also the course) of autoimmune diseases.
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Affiliation(s)
- C Hol
- Department of Medical Microbiology, Public Health Laboratory, Leeuwarden, The Netherlands
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Bloembergen P, Hol C, Hofhuis FM, van Dijk H. Induction of auto-antibody formation in C3H/HeJ mice by cobra venom factor. Int Arch Allergy Appl Immunol 1991; 96:113-8. [PMID: 1769741 DOI: 10.1159/000235481] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Recently, we demonstrated that lipopolysaccharide (LPS)-hyporesponsive C3H/HeJ mice show a very high background number of splenic antibody-forming cells with specificity for bromelain-treated isologous erythrocytes. This background level was not or only slightly enhanced by LPS injection. In this paper it is reported that the existing response of C3H/HeJ mice is about doubled by treatment of the animals with cobra venom factor (CVF). This increase is very similar to the LPS-induced potentiation of the auto-antibody response of C3H/Tif and other LPS-responder mice. The absence of auto-antibodies in the sera of CVF-treated C3H/HeJ mice, however, points at a different mechanism of B cell activation. The mediation of the CVF-induced stimulation of the B cells of C3H/HeJ mice by covalent C3-glycoprotein complexes and the need for an additional stimulus is discussed.
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Affiliation(s)
- P Bloembergen
- Department of Medical Microbiology, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands
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Bloembergen P, Hofhuis FM, Hol C, van Dijk H. Endotoxin-induced auto-immunity in mice. III. Comparison of different endotoxin preparations. Int Arch Allergy Appl Immunol 1990; 92:124-30. [PMID: 2242926 DOI: 10.1159/000235202] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Six different endotoxin preparations derived from Escherichia coli and Salmonella typhimurium subspecies were compared as to their potencies to provoke auto-immune phenomena in mice. The numbers of spleen cells forming antibodies to bromelain-treated isologous erythrocytes or anti-DNA antibodies, the serum levels of these auto-antibodies, and the circulating immune complex titres were determined. As far as comparison on a weight base was concerned, S. typhimurium Re-mutant lipopolysaccharide appeared to be the most active preparation in inducing auto-antibody formation. Upon comparison of amounts with equal activity in the limulus amoebocyte lysate assay, however, S. typhimurium lipid A turned out to be the most potent. The contribution of O-type specific polysaccharides, phosphate groups, and the lipid A moiety to the potencies of the endotoxin preparations is discussed.
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Affiliation(s)
- P Bloembergen
- Department of Medical Microbiology, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands
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Bloembergen P, van Dijk H, Hofhuis FM, van den Heiligenberg P, Willers JM. Endotoxin-induced auto-immunity in mice. II. Reactivity of LPS-hyporesponsive and C5-deficient animals. Int Arch Allergy Appl Immunol 1988; 86:370-4. [PMID: 3410556 DOI: 10.1159/000234621] [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] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Auto-antibody responses and circulating immune complex levels of mice with abnormal reactions to endotoxin were investigated after injection with the bacterial product. It was observed that C3H/HeJ mice displayed very high background plaque-forming cell responses towards bromelain-treated isologous erythrocytes which were slightly enhanced by endotoxin treatment. The same animals, however, did not bear autohaemolysins in their serum, but became so upon endotoxin injection. A possible relationship between the high background reactivity of C3H/HeJ mice and the low toxicity of endotoxin in these animals is discussed. Neither untreated nor lipopolysaccharide-injected C3H/HeJ mice showed significant immune complex levels in their sera. This may be explained by their hyporesponsiveness, but by a low sensitivity to the toxic effects of endotoxin as well. C5-deficient and C5-sufficient mice showed similar auto-immune reactions, indicating that C5a, which is responsible for other effects of endotoxin, is not involved in endotoxin-induced auto-immunity.
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Affiliation(s)
- P Bloembergen
- Section of Experimental Immunology, Medical Faculty, State University of Utrecht, The Netherlands
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