• Timeliness of immunisations in preterm infants in the Netherlands.

      Rouers, Elsbeth D M; Berbers, Guy A M; van Dongen, Josephine A P; Sanders, Elisabeth A M; Bruijning-Verhagen, Patricia (2019-09-16)
    • Determinants of presence and removal of antibiotic resistance genes during WWTP treatment: A cross-sectional study.

      Pallares-Vega, Rebeca; Blaak, Hetty; van der Plaats, Rozemarijn; de Roda Husman, Ana M; Hernandez Leal, Lucia; van Loosdrecht, Mark C M; Weissbrodt, David G; Schmitt, Heike (2019-09-15)
    • Rate constants of hydroxyl radicals reaction with different dissociation species of fluoroquinolones and sulfonamides: Combined experimental and QSAR studies.

      Luo, Xiang; Wei, Xiaoxuan; Chen, Jingwen; Xie, Qing; Yang, Xianhai; Peijnenburg, Willie J G M (2019-09-14)
      Hydroxyl radicals (·OH) initiated degradation is an important process governing fate of aquatic organic micropollutants (OMPs). However, rate constants for aqueous reaction of OMPs with ·OH (kOH) are available only for a limited number of OMPs, which complicates fate assessment of OMPs. Furthermore, molecular structures of many OMPs contain ionizable groups, and the OMPs may dissociate into different anionic/cationic species with different reactivity towards ·OH. Therefore, it is of importance to determine kOH of ionizable OMPs, and to develop quantitative structure-activity relationship (QSAR) models for predicting kOH of OMPs at different ionization forms. Herein kOH values of 9 fluoroquinolones (FQs) and 11 sulfonamides (SAs) at 3 dissociation forms (FQ±/FQ+/FQ-, SA0/SA+/SA-) were determined by competition kinetics experiments. A QSAR model using theoretical molecular structural descriptors was subsequently developed. The QSAR model successfully corroborated previous experimental results, exhibited good statistical performance, and is capable to predict kOH for FQs and SAs with different dissociation forms at environmentally relevant pH conditions. As organic ions have rarely been included in previous QSAR studies, the newly developed model that covers both neutral molecules and ions is of significance for future QSAR development as well as fate assessment of ionizable OMPs.
    • Moderators of Exercise Effects on Cancer-related Fatigue: A Meta-analysis of Individual Patient Data.

      van Vulpen, Jonna K; Sweegers, Maike G; Peeters, Petra H M; Courneya, Kerry S; Newton, Robert U; Aaronson, Neil K; Jacobsen, Paul B; Galvão, Daniel A; Chinapaw, Mai J; Steindorf, Karen; et al. (2019-09-12)
    • Surveillance of infections in long-term care facilities (LTCFs): The impact of participation during multiple years on health care-associated infection incidence.

      Haenen, A P J; Verhoef, L P; Beckers, A; Gijsbers, E F; Alblas, J; Huis, A; Hulscher, M; de Greeff, S C (2019-09-09)
    • From accelerometer output to physical activity intensities in breast cancer patients.

      Sweegers, Maike G; Buffart, Laurien M; Huijsmans, Rosalie J; Konings, Inge R; van Zweeden, Annette A; Brug, Johannes; Chinapaw, Mai J M; Altenburg, Teatske M (2019-09-07)
      We aimed to investigate accelerometer output corresponding to physical activity intensity cut-points based on percentage of peak oxygen consumption (%VO2peak) and Metabolic Equivalent of Task (MET) value in women treated for breast cancer.
    • Cost-effectiveness of selective digestive decontamination (SDD) versus selective oropharyngeal decontamination (SOD) in intensive care units with low levels of antimicrobial resistance: an individual patient data meta-analysis.

      van Hout, Denise; Plantinga, Nienke L; Bruijning-Verhagen, Patricia C; Oostdijk, Evelien A N; de Smet, Anne Marie G A; de Wit, G Ardine; Bonten, Marc J M; van Werkhoven, Cornelis H (2019-09-06)
    • Impact of vertebrate communities on Ixodes ricinus-borne disease risk in forest areas.

      Takumi, Katsuhisa; Sprong, Hein; Hofmeester, Tim R (2019-09-06)
    • Multi-component meningococcal serogroup B (MenB)-4C vaccine induces effective opsonophagocytic killing in children with a complement deficiency.

      van den Broek, B; van Els, C A C M; Kuipers, B; van Aerde, K; Henriet, S S; de Groot, R; de Jonge, M; Langereis, J D; van der Flier, M (2019-09-05)
    • Updated classification of norovirus genogroups and genotypes.

      Chhabra, Preeti; de Graaf, Miranda; Parra, Gabriel I; Chan, Martin Chi-Wai; Green, Kim; Martella, Vito; Wang, Qiuhong; White, Peter A; Katayama, Kazuhiko; Vennema, Harry; et al. (2019-09-04)
    • Abundance and Antimicrobial Resistance of Three Bacterial Species along a Complete Wastewater Pathway.

      Verburg, Ilse; García-Cobos, Silvia; Hernández Leal, Lucia; Waar, Karola; Friedrich, Alex W; Schmitt, Heike (2019-09-03)
      After consumption, antibiotic residues and exposed bacteria end up via the feces in wastewater, and therefore wastewater is believed to play an important role in the spread of antimicrobial resistance (AMR). We investigated the abundance and AMR profiles of three different species over a complete wastewater pathway during a one-year sampling campaign, as well as including antimicrobial consumption and antimicrobial concentrations analysis. A total of 2886 isolates (997 Escherichia coli, 863 Klebsiella spp., and 1026 Aeromonas spp.) were cultured from the 211 samples collected. The bacterial AMR profiles mirrored the antimicrobial consumption in the respective locations, which were highest in the hospital. However, the contribution of hospital wastewater to AMR found in the wastewater treatment plant (WWTP) was below 10% for all antimicrobials tested. We found high concentrations (7-8 logs CFU/L) of the three bacterial species in all wastewaters, and they survived the wastewater treatment (effluent concentrations were around 5 log CFU/L), showing an increase of E. coli in the receiving river after the WWTP discharge. Although the WWTP had no effect on the proportion of AMR, bacterial species and antimicrobial residues were still measured in the effluent, showing the role of wastewater contamination in the environmental surface water.
    • A deliberate choice? Exploring factors related to informed decision-making about childhood vaccination among acceptors, refusers, and partial acceptors.

      Romijnders, Kim A G J; van Seventer, Stephne L; Scheltema, Manon; van Osch, Liesbeth; de Vries, Hein; Mollema, Liesbeth (2019-09-03)
    • Perioperative proADM-change is associated with the development of acute respiratory distress syndrome in critically ill cardiac surgery patients: a prospective cohort study.

      van Paassen, Judith; van Dissel, Jaap T; Hiemstra, Pieter S; Zwaginga, Jaap Jan; Cobbaert, Christa M; Juffermans, Nicole P; de Wilde, Rob B; Stijnen, Theo; de Jonge, Evert; Klautz, Robert J; et al. (2019-09-01)
      Aim: Biomarkers of acute respiratory distress syndrome (ARDS) after cardiac-surgery may help risk-stratification and management. Preoperative single-value proADM increases predictive capacity of scoring-system EuroSCORE. To include the impact of surgery, we aim to assess the predictive value of the perioperative proADM-change on development of ARDS in 40 cardiac-surgery patients. Materials & methods: ProADM was measured in nine sequential blood samples. The Berlin definition of ARDS was used. For data-analyses, a multivariate model of EuroSCORE and perioperative proADM-change, linear mixed models and logistic regression were used. Results: Perioperative proADM-change was associated with ARDS after cardiac-surgery, and it was superior to EuroSCORE. A perioperative proADM-change >1.5 nmol/l could predict ARDS. Conclusion: Predicting post-surgery ARDS with perioperative proADM-change enables clinicians to intensify lung-protective interventions and individualized fluid therapy to minimize secondary injury.
    • Competition between Escherichia coli Populations with and without Plasmids Carrying a Gene Encoding Extended-Spectrum Beta-Lactamase in the Broiler Chicken Gut.

      Fischer, Egil A J; Dierikx, Cindy M; van Essen-Zandbergen, Alieda; Mevius, Dik; Stegeman, Arjan; Velkers, Francisca C; Klinkenberg, Don (2019-09-01)
      Extended-spectrum-beta-lactamase (ESBL)/AmpC-producing Escherichia coli strains are widely found in E. coli isolates from broiler feces, largely due to the presence of the blaCTX-M-1 gene on IncI1 plasmids. Plasmid carriage is theorized to cause fitness loss and thus should decrease under conditions of reduced antibiotic use. However, in vitro studies showed plasmid carriage to increase in the absence of antimicrobials, due to plasmid conjugation. We investigated whether this translates to increased levels of plasmid in the gastrointestinal tracts of chickens, where conjugation rates may be different and subtle differences in growth rates may have a larger impact on colonization. Eight groups of five chickens were orally inoculated at 4 days of age with a 0.5-ml volume containing 106 CFU/ml E. coli cells, of which 0%, 0.1%, 10%, or 100% carried the IncI1 plasmid with the gene blaCTX-M-1 At 13 time points during 41 days, fecal samples were taken from each chicken. E. coli strains with and without plasmids were quantified. Trends in E. coli subpopulations were analyzed using generalized linear mixed models, and population dynamics were studied by fitting to a mechanistic model. Trends in E. coli subpopulations were different between groups rather than between individual chickens, suggesting substantial levels of E. coli exchange between chickens in a group. The IncI1 plasmid carrying blaCTX-M-1 was transferred with conjugation coefficients at levels higher than those observed in vitro Across groups, the plasmids disappeared or were established independently of the initial fraction of plasmid-carrying E. coli, but no major increase occurred as observed in vitro Differences in growth rates were observed, but competitive exclusion of plasmid-carrying variants was counteracted by conjugation.IMPORTANCE Bacteria that produce extended-spectrum beta-lactamases are resistant to an important class of antimicrobials in human and veterinary medicine. Reduction in antibiotic use is expected to decrease the prevalence of resistance. However, resistance genes often lie on plasmids which can be copied and transferred to other bacteria by conjugation, so in vitro resistance was observed to increase in the absence of antimicrobials. We sought to determine whether this also occurs in the chicken gut and if competitive exclusion by similar E. coli variants without the resistance occurred. We studied the excretion of E. coli carrying IncI1 plasmids with the blaCTX-M-1 resistance gene in small groups of broiler chickens, after inoculating the chickens with E. coli suspensions containing different fractions of plasmid-carrying cells. Our results showed little variation between chickens within groups but large differences between groups that were independent of the ratio of variants with and without the plasmid and with persistence or extinction of the plasmid. However, there was no major plasmid increase as observed in vitro We conclude that in vivo studies with sufficient independent replications are important for intervention studies on plasmid-mediated antimicrobial resistance.
    • Associations between common respiratory viruses and invasive group A streptococcal infection: A time-series analysis.

      de Gier, Brechje; Vlaminckx, Bart J M; Woudt, Sjoukje H S; van Sorge, Nina M; van Asten, Liselotte (2019-09-01)
    • A comparison of linear regression, regularization, and machine learning algorithms to develop Europe-wide spatial models of fine particles and nitrogen dioxide.

      Chen, Jie; de Hoogh, Kees; Gulliver, John; Hoffmann, Barbara; Hertel, Ole; Ketzel, Matthias; Bauwelinck, Mariska; van Donkelaar, Aaron; Hvidtfeldt, Ulla A; Katsouyanni, Klea; et al. (2019-09-01)
      Empirical spatial air pollution models have been applied extensively to assess exposure in epidemiological studies with increasingly sophisticated and complex statistical algorithms beyond ordinary linear regression. However, different algorithms have rarely been compared in terms of their predictive ability. This study compared 16 algorithms to predict annual average fine particle (PM2.5) and nitrogen dioxide (NO2) concentrations across Europe. The evaluated algorithms included linear stepwise regression, regularization techniques and machine learning methods. Air pollution models were developed based on the 2010 routine monitoring data from the AIRBASE dataset maintained by the European Environmental Agency (543 sites for PM2.5 and 2399 sites for NO2), using satellite observations, dispersion model estimates and land use variables as predictors. We compared the models by performing five-fold cross-validation (CV) and by external validation (EV) using annual average concentrations measured at 416 (PM2.5) and 1396 sites (NO2) from the ESCAPE study. We further assessed the correlations between predictions by each pair of algorithms at the ESCAPE sites. For PM2.5, the models performed similarly across algorithms with a mean CV R2 of 0.59 and a mean EV R2 of 0.53. Generalized boosted machine, random forest and bagging performed best (CV R2~0.63; EV R2 0.58-0.61), while backward stepwise linear regression, support vector regression and artificial neural network performed less well (CV R2 0.48-0.57; EV R2 0.39-0.46). Most of the PM2.5 model predictions at ESCAPE sites were highly correlated (R2 > 0.85, with the exception of predictions from the artificial neural network). For NO2, the models performed even more similarly across different algorithms, with CV R2s ranging from 0.57 to 0.62, and EV R2s ranging from 0.49 to 0.51. The predicted concentrations from all algorithms at ESCAPE sites were highly correlated (R2 > 0.9). For both pollutants, biases were low for all models except the artificial neural network. Dispersion model estimates and satellite observations were two of the most important predictors for PM2.5 models whilst dispersion model estimates and traffic variables were most important for NO2 models in all algorithms that allow assessment of the importance of variables. Different statistical algorithms performed similarly when modelling spatial variation in annual average air pollution concentrations using a large number of training sites.
    • A Systematic Review of Social Contact Surveys to Inform Transmission Models of Close-contact Infections.

      Hoang, Thang; Coletti, Pietro; Melegaro, Alessia; Wallinga, Jacco; Grijalva, Carlos G; Edmunds, John W; Beutels, Philippe; Hens, Niel (2019-09-01)