• Protection of drinking water resources from agricultural pressures: Effectiveness of EU regulations in the context of local realities.

      Wuijts, Susanne; Claessens, Jacqueline; Farrow, Luke; Doody, Donnacha G; Klages, Susanne; Christophoridis, Chris; Cvejić, Rozalija; Glavan, Matjaž; Nesheim, Ingrid; Platjouw, Froukje; et al. (2021-03-15)
    • Mortality Following Infection in Europe: A Retrospective Multicenter Case-Control Study.

      Czepiel, Jacek; Krutova, Marcela; Mizrahi, Assaf; Khanafer, Nagham; Enoch, David A; Patyi, Márta; Deptuła, Aleksander; Agodi, Antonella; Nuvials, Xavier; Pituch, Hanna; et al. (2021-03-13)
      We aimed to describe the clinical presentation, treatment, outcome and report on factors associated with mortality over a 90-day period in Clostridioides difficile infection (CDI). Descriptive, univariate, and multivariate regression analyses were performed on data collected in a retrospective case-control study conducted in nine hospitals from seven European countries. A total of 624 patients were included, of which 415 were deceased (cases) and 209 were still alive 90 days after a CDI diagnosis (controls). The most common antibiotics used previously in both groups were β-lactams; previous exposure to fluoroquinolones was significantly (p = 0.0004) greater in deceased patients. Multivariate logistic regression showed that the factors independently related with death during CDI were older age, inadequate CDI therapy, cachexia, malignancy, Charlson Index, long-term care, elevated white blood cell count (WBC), C-reactive protein (CRP), bacteraemia, complications, and cognitive impairment. In addition, older age, higher levels of WBC, neutrophil, CRP or creatinine, the presence of malignancy, cognitive impairment, and complications were strongly correlated with shortening the time from CDI diagnosis to death. CDI prevention should be primarily focused on hospitalised elderly people receiving antibiotics. WBC, neutrophil count, CRP, creatinine, albumin and lactate levels should be tested in every hospitalised patient treated for CDI to assess the risk of a fatal outcome.
    • Contribution of pristine and reduced microbial extracellular polymeric substances of different sources to Cu(II) reduction.

      Xu, Hang; He, Erkai; Peijnenburg, Willie J G M; Song, Lan; Zhao, Ling; Xu, Xiaoyun; Cao, Xinde; Qiu, Hao (2021-03-12)
    • Cost-effectiveness of a stepwise cardiometabolic disease prevention program: results of a randomized controlled trial in primary care.

      Stol, Daphne M; Over, Eelco A B; Badenbroek, Ilse F; Hollander, Monika; Nielen, Mark M J; Kraaijenhagen, Roderik A; Schellevis, François G; de Wit, Niek J; de Wit, G Ardine (2021-03-11)
    • The mediating role of lifestyle in the relationship between shift work, obesity and diabetes.

      Hulsegge, Gerben; Proper, Karin I; Loef, Bette; Paagman, Heleen; Anema, Johannes R; van Mechelen, Willem (2021-03-11)
      In this cross-sectional study, 3188 shift workers and 6395 non-shift workers participated between 2013 and 2018 in periodical occupational health checks. Weight and height were objectively measured to calculate obesity (BMI ≥ 30 kg/m2). Diabetes status, physical activity, diet, smoking, and sleep quality were assessed using standardized questionnaires. Structural equation models adjusted for relevant confounders were used to analyze the mediating role of lifestyle in the relationships between shift work, and obesity and diabetes.
    • Inactivation of Trichinella muscle larvae at different time-temperature heating profiles simulating home-cooking.

      Franssen, Frits; Deng, Huifang; Swart, Arno; Marinović, Axel Bonačić; Liu, Xiaolei; Liu, Mingyuan; Van Der Giessen, Joke (2021-03-11)
    • Human reading computer automated reading of chest X-rays in a tuberculosis screening programme in Romania.

      de Vries, Gerard; Gainaru, Dan; Keizer, Sytze; Mahler, Beatrice; Radulescu, Ileana; Zamfirescu, Marina; Abubakar, Ibrahim (2021-03-10)
    • National point prevalence study on carriage of multidrug-resistant microorganisms in Dutch long-term care facilities in 2018.

      van Kleef, Esther; Wielders, Cornelia C H; Schouls, Leo M; Feenstra, Sabiena G; Hertogh, Cees M P M; Bonten, Marc J M; van Weert, Yolanda; Tostmann, Alma; van der Lubben, Mariken; de Greeff, Sabine C (2021-03-10)
    • Biomarkers of effect as determined in human biomonitoring studies on hexavalent chromium and cadmium in the period 2008-2020.

      Ventura, Célia; Gomes, Bruno Costa; Oberemm, Axel; Louro, Henriqueta; Huuskonen, Pasi; Mustieles, Vicente; Fernández, Mariana F; Ndaw, Sophie; Mengelers, Marcel; Luijten, Mirjam; et al. (2021-03-10)
    • Seoul Virus in Pet and Feeder Rats in The Netherlands.

      Cuperus, Tryntsje; de Vries, Ankje; Hoornweg, Tabitha E; Fonville, Manoj; Jaarsma, Ryanne I; Opsteegh, Marieke; Maas, Miriam (2021-03-10)
      Seoul virus (SEOV) is a zoonotic orthohantavirus carried by rats. In humans, SEOV can cause hemorrhagic fever with renal syndrome. Recent human SEOV cases described in the USA, United Kingdom, France and the Netherlands were associated with contact with pet or feeder rats. The prevalence of SEOV in these types of rats is unknown. We collected 175 pet and feeder rats (Rattus norvegicus) from private owners, ratteries and commercial breeders/traders in the Netherlands. Lung tissue of the rats was tested using a SEOV real-time RT-qPCR and heart fluid was tested for the presence of antibodies against SEOV. In all three investigated groups, RT-qPCR-positive rats were found: in 1/29 rats from private owners (3.6%), 2/56 rats from ratteries (3.4%) and 11/90 rats from commercial breeders (12.2%). The seroprevalence was largely similar to the prevalence calculated from RT-qPCR-positive rats. The SEOV sequences found were highly similar to sequences previously found in domesticated rats in Europe. In conclusion, SEOV is spread throughout different populations of domesticated rats.
    • The extent of carbapenemase-encoding genes in public genome sequences.

      Janse, Ingmar; Beeloo, Rick; Swart, Arno; Visser, Michael; Schouls, Leo; van Duijkeren, Engeline; van Passel, Mark W J (2021-03-09)
      Genome sequences provide information on the genetic elements present in an organism, and currently there are databases containing hundreds of thousands of bacterial genome sequences. These repositories allow for mining patterns concerning antibiotic resistance gene occurrence in both pathogenic and non-pathogenic bacteria in e.g. natural or animal environments, and link these to relevant metadata such as bacterial host species, country and year of isolation, and co-occurrence with other resistance genes. In addition, the advances in the prediction of mobile genetic elements, and discerning chromosomal from plasmid DNA, broadens our view on the mechanism mediating dissemination. In this study we utilize the vast amount of data in the public database PATRIC to investigate the dissemination of carbapenemase-encoding genes (CEGs), the emergence and spread of which is considered a grave public health concern. Based on publicly available genome sequences from PATRIC and manually curated CEG sequences from the beta lactam database, we found 7,964 bacterial genomes, belonging to at least 70 distinct species, that carry in total 9,892 CEGs, amongst which blaNDM, blaOXA, blaVIM, blaIMP and blaKPC. We were able to distinguish between chromosomally located resistance genes (4,137; 42%) and plasmid-located resistance genes (5,753; 58%). We found that a large proportion of the identified CEGs were identical, i.e. displayed 100% nucleotide similarity in multiple bacterial species (8,361 out of 9,892 genes; 85%). For example, the New Delhi metallo-beta-lactamase NDM-1 was found in 42 distinct bacterial species, and present in seven different environments. Our data show the extent of carbapenem-resistance far beyond the canonical species Acetinobacter baumannii, Klebsiella pneumoniae or Pseudomonas aeruginosa. These types of data complement previous systematic reviews, in which carbapenem-resistant Enterobacteriaceae were found in wildlife, livestock and companion animals. Considering the widespread distribution of CEGs, we see a need for comprehensive surveillance and transmission studies covering more host species and environments, akin to previous extensive surveys that focused on extended spectrum beta-lactamases. This may help to fully appreciate the spread of CEGs and improve the understanding of mechanisms underlying transmission, which could lead to interventions minimizing transmission to humans.
    • Potency of olorofim (F901318) compared to contemporary antifungal agents against clinical isolates, and review of azole resistance phenotype and genotype epidemiology in China.

      Su, Huilin; Zhu, Min; Tsui, Clement Kin-Ming; van der Lee, Henrich; Tehupeiory-Kooreman, Marlou; Zoll, Jan; Engel, Tobias; Li, Li; Zhu, Junhao; Lu, Zihan; et al. (2021-03-08)
      Triazole resistance in A. fumigatus is an increasing worldwide problem that causes major challenges in the management of aspergillosis. New antifungal drugs are needed with novel targets, that are effective in triazole-resistant infection. In this study, we retrospectively evaluated potency of the novel drug olorofim compared to contemporary antifungal agents against 111 clinical A. fumigatus isolates collected from Huashan Hospital, Shanghai, China, using EUCAST methodology, and reviewed the literature on triazole resistant A. fumigatus published between 1966 and 2020 in China. Olorofim was active in vitro against all tested A. fumigatus isolates with MIC90 of 0.031mg/L (range 0.008-0.062 mg/L). For 4 triazole-resistant A. fumigatus (TRAF) isolates, the olorofim MIC ranged between 0.016-0.062mg/L. The reported rates of TRAF in China is 2.5% - 5.56% for clinical isolates, and 0-1.4% for environmental isolates.TR34/L98H/S297T/F495I is the predominant resistance mechanism, followed by TR34/L98H. Non TR-mediated TRAF isolates, mostly harboring a cyp51A single point mutation, showed greater genetic diversity than TR-mediated resistant isolates. Resistance due toTR34/L98H and TR34/L98H/S297T/F495I mutations among TRAF isolates might have evolved from separate local isolates in China. Continuous isolation of TRAF in China underscores the need for systematic resistance surveillance as well as the need for novel drug targets such as olorofim.
    • Does surrounding greenness moderate the relationship between apparent temperature and physical activity? Findings from the PHENOTYPE project.

      Ho, Janice Y; Zijlema, Wilma L; Triguero-Mas, Margarita; Donaire-Gonzalez, David; Valentín, Antònia; Ballester, Joan; Chan, Emily Y Y; Goggins, William B; Mo, Phoenix K H; Kruize, Hanneke; et al. (2021-03-08)
    • Measles outbreak in complex emergency: estimating vaccine effectiveness and evaluation of the vaccination campaign in Borno State, Nigeria, 2019.

      Jean Baptiste, Anne Eudes; Wagai, John; Luce, Richard; Masresha, Balcha; Klinkenberg, Don; Veldhuijzen, Irene; Oteri, Joseph; Dieng, Boubacar; Ikeonu, Obianuju Caroline; Meleh, Sule; et al. (2021-03-04)
    • Cost of childhood acute otitis media in primary care in the Netherlands: economic analysis alongside a cluster randomised controlled trial.

      van Uum, Rick T; Venekamp, Roderick P; Pasmans, Clémence T B; de Wit, G Ardine; Sjoukes, Alies; van der Pol, Alma C; Damoiseaux, Roger A M J; Schilder, Anne G M (2021-03-04)
    • Both non-smoking youth and smoking adults like sweet and minty e-liquid flavors more than tobacco flavor.

      Krüsemann, Erna J Z; van Tiel, Loes; Pennings, Jeroen L A; Vaessen, Wim; de Graaf, Kees; Talhout, Reinskje; Boesveldt, Sanne (2021-03-04)
    • Epidemiology and transmission characteristics of early COVID-19 cases, January 20 - March 19 2020, in Bavaria, Germany.

      Böhm, S; Woudenberg, T; Chen, D; Marosevic, D V; Böhmer, M M; Hansen, L; Wallinga, J; Sing, A; Katz, K (2021-03-02)
    • Substitution of pure fruit juice for fruit and sugar-sweetened beverages and cardiometabolic risk in EPIC-NL: a prospective cohort study.

      Scheffers, Floor R; Boer, Jolanda M A; Wijga, Alet H; van der Schouw, Yvonne T; Smit, Henriëtte A; Verschuren, W M Monique (2021-03-01)
    • An efficient molecular approach to distinguish chains of measles virus transmission in the elimination phase.

      Bodewes, Rogier; Reijnen, Linda; Zwagemaker, Florian; Kohl, Robert H G; Kerkhof, Jeroen; Veldhuijzen, Irene K; van Binnendijk, Rob (2021-03-01)
      Measles viruses continue to spread globally, despite the availability of a safe and effective vaccine. Molecular surveillance of measles virus has become an essential tool to demonstrate whether cascades of infections in a certain region or country are the result of endemic spread or the repeatedly introduction of the virus in contained outbreaks. Currently, molecular surveillance of measles viruses worldwide is mainly based on 450 nucleotides of the C-terminal region of the nucleoprotein (N450). However, as a result of the disappearance of particular measles virus clades over the past decades, this gene segment does not provide sufficient resolution anymore to answer these questions. To increase the molecular resolution, sequence data were collected from three regions of the measles virus genome, the partial non-coding region between the M and F gene (M-F NCR4465-4754), partial H gene (H8022-8621) and the partial L gene (L10724-11438) for measles viruses detected in 2018 and 2019 in the Netherlands. Analysis of obtained sequence data indicated that sequencing of these three regions resulted in an increase in molecular resolution for measles virus genotype B3 and D8 viruses, two of the four global genotypes currently predominant in the European region. Furthermore, this improved resolution was sufficient to support an epidemiology characterized by repeat introduction of measles virus rather than endemic virus spread. In conclusion, sequencing of the M-F NCR4465-4754, H8022-8621 and L10724-11438 regions of the measles virus is an efficient and useful approach for molecular surveillance of measles viruses.
    • Diagnostic dilemma in COVID-19-associated pulmonary aspergillosis - Authors' reply.

      Koehler, Philipp; White, P Lewis; Verweij, Paul E; Cornely, Oliver A (2021-03-01)