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Euro Surveillance : Bulletin Europeen... Feb 2024A surge in gonorrhoea in Denmark has occurred since 2022, a 46% increase from 2021. National surveillance, leveraging mandatory reporting and epidemiological data,...
A surge in gonorrhoea in Denmark has occurred since 2022, a 46% increase from 2021. National surveillance, leveraging mandatory reporting and epidemiological data, highlights three distinct clades linked to heterosexual transmission. Despite the rise, these exhibit high susceptibility, contrasting MSM-associated strains. Geographical hotspots and age-specific patterns further illuminate transmission dynamics. The combination of genomic and epidemiological data provides novel insights into the evolving landscape of gonorrhoea, indicating potential shifts in infection dynamics and transmissibility.
Topics: Humans; Anti-Bacterial Agents; Denmark; Gonorrhea; Heterosexuality; Neisseria gonorrhoeae
PubMed: 38362625
DOI: 10.2807/1560-7917.ES.2024.29.7.2400059 -
BMC Infectious Diseases Feb 2024In Japan, carbapenem-resistant Enterobacterales (CRE) infections were incorporated into the National Epidemiological Surveillance of Infectious Diseases (NESID) in 2014,...
The importance of meropenem resistance, rather than imipenem resistance, in defining carbapenem-resistant Enterobacterales for public health surveillance: an analysis of national population-based surveillance.
BACKGROUND
In Japan, carbapenem-resistant Enterobacterales (CRE) infections were incorporated into the National Epidemiological Surveillance of Infectious Diseases (NESID) in 2014, necessitating mandatory reporting of all CRE infections cases. Subsequently, pathogen surveillance was initiated in 2017, which involved the collection and analysis of CRE isolates from reported cases to assess carbapenemase gene possession. In this surveillance, CRE is defined as (i) minimum inhibitory concentration (MIC) of meropenem ≥2 mg/L (MEPM criteria) or (ii) MIC of imipenem ≥2 mg/L and MIC of cefmetazole ≥64 mg/L (IPM criteria). This study examined whether the current definition of CRE surveillance captures cases with a clinical and public health burden.
METHODS
CRE isolates from reported cases were collected from the public health laboratories of local governments, which are responsible for pathogen surveillance. Antimicrobial susceptibility tests were conducted on these isolates to assess compliance with the NESID CRE definition. The NESID data between April 2017 and March 2018 were obtained and analyzed using antimicrobial susceptibility test results.
RESULTS
In total, 1681 CRE cases were identified during the study period, and pathogen surveillance data were available for 740 (44.0%) cases. Klebsiella aerogenes and Enterobacter cloacae complex were the dominant species, followed by Klebsiella pneumoniae and Escherichia coli. The rate of carbapenemase gene positivity was 26.5% (196/740), and 93.4% (183/196) of these isolates were of the IMP type. Meanwhile, 315 isolates were subjected to antimicrobial susceptibility testing. Among them, 169 (53.7%) fulfilled only the IPM criteria (IPM criteria-only group) which were susceptible to meropenem, while 146 (46.3%) fulfilled the MEPM criteria (MEPM criteria group). The IPM criteria-only group and MEPM criteria group significantly differed in terms of carbapenemase gene positivity (0% vs. 67.8%), multidrug resistance rates (1.2% vs. 65.8%), and mortality rates (1.8% vs 6.9%).
CONCLUSION
The identification of CRE cases based solely on imipenem resistance has had a limited impact on clinical management. Emphasizing resistance to meropenem is crucial in defining CRE, which pose both clinical and public health burden. This emphasis will enable the efficient allocation of limited health and public health resources and preservation of newly developed antimicrobials.
Topics: Humans; Meropenem; Imipenem; Public Health Surveillance; Bacterial Proteins; beta-Lactamases; Cefmetazole; Escherichia coli; Anti-Infective Agents; Microbial Sensitivity Tests; Anti-Bacterial Agents
PubMed: 38360618
DOI: 10.1186/s12879-024-09107-4 -
Dental Materials : Official Publication... Mar 2024The Dental Biomaterials Adverse Reaction Unit was initiated by the Norwegian health authorities in 1992 as a response to the public concern regarding the safety of...
OBJECTIVES
The Dental Biomaterials Adverse Reaction Unit was initiated by the Norwegian health authorities in 1992 as a response to the public concern regarding the safety of dental amalgam and other dental materials. In this paper, experiences from the Unit are briefly summarized.
METHODS
The Norwegian health authorities' strategy included four main topics: (i) development of a manufacturer-independent system for monitoring adverse reactions related to dental materials, (ii) funding of a specialty unit for clinical examinations of referred patients, (iii) development of official guidelines for examination and treatment of patients with health complaints attributed to dental materials, and (iv) funding of an experimental treatment project for patients with health complaints attributed to dental amalgam.
RESULTS
From the start, more than 2700 adverse reaction reports were received. In the initial years, amalgam was the most frequent material mentioned in the reports. Reports about polymer-based composite materials have not increased after the prohibition of amalgam in Norway. Clinical examination of referred patients is complex and time consuming, and it is important to consider differential diagnoses. There are methodological challenges associated with the design of experimental treatments used on patients with adverse reactions attributed to dental materials. However, the results from the treatment project indicate lower symptom load after replacement of amalgam with other dental restorative materials.
SIGNIFICANCE
Producer independent adverse reaction reporting can provide valuable information about the safety of these materials and could serve as a complement to the mandatory reporting system described in the European medical device regulations (MDR).
Topics: Humans; Dental Materials; Dental Amalgam; Dental Restoration, Permanent; Norway
PubMed: 38336526
DOI: 10.1016/j.dental.2024.01.004 -
NTM Mar 2024This article examines the impact of the reporting practice and paper technologies like forms on reports that were later used for national morbidity statistics by...
[Mandatory Reporting as the Basis of Epidemiological Statistics: The Impact of the Reporting Practice and Usage of Paper Technologies on the Informative Content of Morbidity Statistics 1886-1921].
This article examines the impact of the reporting practice and paper technologies like forms on reports that were later used for national morbidity statistics by studying the Swiss reporting system for infectious diseases between 1886 and 1921. Analysing the production processes of notifications shows the difficulties and solutions in the implementation of the statutory reporting process. Two disease outbreaks-a smallpox outbreak in Schaffhausen and a typhoid outbreak in the canton of Lucerne-serve as case studies. It is shown that reports are not only objective representations of diseases, but also symbolize the medico-social interactions that produce them, timed by administrative tools like reporting forms and the act of reporting. This destabilises historical statistics and illustrates the complexity of the historical source material, as these interactions and their impact on reporting must be considered. These findings are further supported by examining the Swiss reporting system during the Spanish flu of 1918 and its failure to record influenza cases.
Topics: History, 20th Century; Humans; Mandatory Reporting; Influenza Pandemic, 1918-1919; Communicable Diseases; Disease Outbreaks; Influenza, Human; Morbidity
PubMed: 38319387
DOI: 10.1007/s00048-024-00375-4 -
Frontiers in Nutrition 2023Food prices have experienced unprecedented increases in recent times. Simultaneously, grocers are facing allegations of capitalizing on inflation to generate...
Food prices have experienced unprecedented increases in recent times. Simultaneously, grocers are facing allegations of capitalizing on inflation to generate unjustifiable profits. Escalating expenses and a lack of transparency have engendered heightened consumer skepticism. This perceived presence of barriers and excessive profitability gives rise to ethical concerns. Our case study delves into the ethical landscape surrounding Canadian grocers, aiming to probe the public's demand for accountability. To comprehend the factors responsible for the transformation in consumer perception of Canadian grocers in 2022, we conducted an analysis utilizing data from consumers, corporate watchdogs, and industry sources. We extended the paradox perspective on corporate sustainability framework to include a historical aspect to use as our analytical lens. This study sheds light on the alterations in circumstances that have led Canadian consumers to question entire industries and accounting practices that were previously considered unproblematic. As a remedy, we recommend the establishment of a mandatory code of conduct for grocers and an enhancement in the transparency of financial reporting. Paradoxically, corporate profits may continue to grow when societal needs are no longer perceived as being neglected or, even worse, exploited.
PubMed: 38283908
DOI: 10.3389/fnut.2023.1284377 -
BMJ Paediatrics Open Jan 2024Increasingly large numbers of children and youth are migrating across international borders with many seeking employment in both formal and informal work sectors. These... (Review)
Review
Increasingly large numbers of children and youth are migrating across international borders with many seeking employment in both formal and informal work sectors. These young people are at high risk of exploitation. Healthcare professionals need to be able to recognise vulnerable patients and advocate for their protection and safety, yet there is a paucity of literature that provides guidance on how to accomplish this. The goal of this paper is to provide guidance to clinicians on identifying and assisting migrant paediatric patients at risk of being exploited in the work sector, including conducting a risk assessment and making decisions about mandatory reporting. First, the best interest of the youth within their cultural context should be examined respecting their desires and goals, as well as immediate and longer-term physical health, mental health and safety issues. Second, clinicians should consider the best interest of the family, with attention to varying socioeconomic and psychosocial conditions including acculturation, immigration challenges, as well as cultural norms and values. Third, the situation must be evaluated within the legal framework of the host country regarding child labour, exploitation and trafficking. Cultural humility, open-mindedness, the active engagement of patients and families and an understanding of child labour within cultural contexts and legal statutes will empower healthcare professionals to identify and support patients at risk of exploitation in work settings. These recommendations serve to prioritise the best interests of vulnerable working migrant children and youth. The healthcare and migration systems of the USA will be used as a case for exploration.
Topics: Adolescent; Humans; Child; Transients and Migrants; Emigration and Immigration; Mental Health; Child Labor; Delivery of Health Care
PubMed: 38272540
DOI: 10.1136/bmjpo-2023-002427 -
Journal of Comparative Effectiveness... Mar 2024Catheter ablation is used to treat symptomatic atrial fibrillation (AF) and is performed using either cryoballoon (CB) or radiofrequency (RF) ablation. There is limited...
Catheter ablation is used to treat symptomatic atrial fibrillation (AF) and is performed using either cryoballoon (CB) or radiofrequency (RF) ablation. There is limited real world data of CB and RF in the US as healthcare codes are agnostic of energy modality. An alternative method is to analyze patients' electronic health records (EHRs) using Optum's EHR database. To determine the feasibility of using patients' EHRs with natural language processing (NLP) to distinguish CB versus RF ablation procedures. Optum de-identified EHR dataset, Optum Cardiac Ablation NLP Table. This was a retrospective analysis of existing de-identified EHR data. Medical codes were used to create an ablation validation table. Frequency analysis was used to assess ablation procedures and their associated note terms. Two cohorts were created (1) index procedures, (2) multiple procedures. Possible note term combinations included (1) cryoablation (2) radiofrequency (3) ablation, or (4) both. Of the 40,810 validated cardiac ablations, 3777 (9%) index ablation procedures had available and matching NLP note terms. Of these, 22% (n = 844) were classified as ablation, 27% (n = 1016) as cryoablation, 49% (n = 1855) as radiofrequency ablation, and 1.6% (n = 62) as both. In the multiple procedures analysis, 5691 (14%) procedures had matching note terms. 24% (n = 1362) were classified as ablation, 27% as cryoablation, 47% as radiofrequency ablation, and 2% as both. NLP has potential to evaluate the frequency of cardiac ablation by type, however, for this to be a reliable real-world data source, mandatory data entry by providers and standardized electronic health reporting must occur.
Topics: Humans; Treatment Outcome; Cardiac Catheters; Retrospective Studies; Electronic Health Records; Natural Language Processing; Atrial Fibrillation; Catheter Ablation
PubMed: 38261335
DOI: 10.57264/cer-2023-0053 -
Euro Surveillance : Bulletin Europeen... Jan 2024BackgroundContact tracing was one of the central non-pharmaceutical interventions implemented worldwide to control the spread of SARS-CoV-2, but its effectiveness...
BackgroundContact tracing was one of the central non-pharmaceutical interventions implemented worldwide to control the spread of SARS-CoV-2, but its effectiveness depends on its ability to detect contacts.AimEvaluate the proportion of secondary infections captured by the contact tracing system in Geneva.MethodsWe analysed 166,892 concomitant infections occurring at the same given address from June 2020 until February 2022 using an extensive operational database of SARS-CoV-2 tests in Geneva. We used permutation to compare the total number of secondary infections occurring at the same address with that reported through manual contact tracing.ResultsContact tracing captured on average 41% of secondary infections, varying from 23% during epidemic peaks to 60% during low epidemic activity. People living in wealthy neighbourhoods were less likely to report contacts (odds ratio (OR): 1.6). People living in apartment buildings were also less likely to report contacts than those living in a house (OR: 1.1-3.1) depending on the SARS-CoV-2 variant, the building size and the presence of shops. This under-reporting of contacts in apartment buildings decreased during periods of mandatory wearing of face masks and restrictions on private gatherings.ConclusionContact tracing alone did not detect sufficient secondary infections to reduce the spread of SARS-CoV-2. Campaigns targeting specific populations, such as those in wealthy areas or apartment buildings, could enhance coverage. Additionally, measures like wearing face masks, improving ventilation and implementing restrictions on gatherings should also be considered to reduce infections resulting from interactions that may not be perceived as high risk.
Topics: Humans; COVID-19; SARS-CoV-2; Contact Tracing; Switzerland; Coinfection
PubMed: 38240059
DOI: 10.2807/1560-7917.ES.2024.29.3.2300228 -
The Lancet Regional Health. Southeast... Jan 2024In developing/underdeveloped countries there is still a great burden of adverse drug reaction (ADR), morbidity and mortality because of poor regulations and... (Review)
Review
In developing/underdeveloped countries there is still a great burden of adverse drug reaction (ADR), morbidity and mortality because of poor regulations and implementation of preventive measures. These countries try to copy/follow guidelines from international bodies like American Urology Association (AUA), European Association of Urology (EAU), AGS, UMC and WHO irrespective of their country of origin and success in implementation. Although recommendations of these organizations are obligatory, yet these are taken as the gold standard for good clinical practices. This manuscript highlights difference in view point of various apex health organizations in formulating health policies for prevention, diagnosis, treatment and ADR monitoring for urological disorders. Lacking role of regulatory bodies in implementation of existing policies may lead to potentially inappropriate medication and produce a great economic burden. This analysis has prompted us to recommend that these apex bodies should have better coordination in producing a single value document, make it mandatory part of curricula in medical schools for better awareness, awareness campaigns and separate reporting column in ADR form.
PubMed: 38234703
DOI: 10.1016/j.lansea.2023.100330 -
Using whole genome sequencing to characterize isolates at a tertiary center in Melbourne, Australia.Antimicrobial Stewardship & Healthcare... 2024infection (CDI) is the commonest cause of healthcare-associated diarrhea and undergoes standardized surveillance and mandatory reporting in most Australian states and...
OBJECTIVE
infection (CDI) is the commonest cause of healthcare-associated diarrhea and undergoes standardized surveillance and mandatory reporting in most Australian states and territories. Historically attributed to nosocomial spread, local and international whole genome sequencing (WGS) data suggest varied sources of acquisition. This study describes genotypes isolated at a tertiary center in Melbourne, Australia, their likely source of acquisition, and common risk factors.
DESIGN
Retrospective observational study.
SETTING
The Royal Melbourne Hospital (RMH), a 570-bed tertiary center in Victoria, Australia.
METHODS
Short-read whole genome sequencing was performed on 75 out of 137 isolates obtained from 1/5/2021 to 28/2/2022 and compared to previous data from 8/11/2015 to 1/11/2016. Existing data from infection control surveillance and electronic medical records were used for epidemiological and risk factor analysis.
RESULTS
Eighty-five (62.1%) of the 137 cases were defined as healthcare-associated from epidemiological data. On genome sequencing, 33 different multi-locus sequence type (MLST) subtypes were identified, with changes in population structure compared to the 2015-16 period. Risk factors for CDI were present in 130 (94.9%) cases, including 108 (78.8%) on antibiotics, 86 (62.8%) on acid suppression therapy, and 25 (18.2) on chemotherapy.
CONCLUSION
In both study periods, most isolates were not closely related, suggesting varied sources of acquisition and that spread of within the hospital was unlikely. Current infection control precautions may therefore warrant review. Underlying risk factors for CDI were common and may contribute to the proportion of healthcare-associated infections in the absence of proven hospital transmission.
PubMed: 38234420
DOI: 10.1017/ash.2023.529