• Transmission of ESBL-producing Escherichia coli between broilers and humans on broiler farms.

      van Hoek, Angela H A M; Dierikx, Cindy; Bosch, Thijs; Schouls, Leo; van Duijkeren, Engeline; Visser, Michael (2020-03-01)
    • Transport of bacteriophage MS2 and PRD1 in saturated dune sand under suboxic conditions.

      Hornstra, Luc M; Schijven, Jack F; Waade, Andrea; Prat, Gemma Serra; Smits, Frank J C; Cirkel, Gijsbert; Stuyfzand, Pieter J; Medema, Gertjan J (2018-03-24)
      Soil passage of (pretreated) surface water to remove pathogenic microorganisms is a highly efficient process under oxic conditions, reducing microorganism concentrations about 8 log10 within tens of meters. However, under anoxic conditions, it has been shown that removal of microorganisms can be limited very much. Setback distances for adequate protection of natural groundwater may, therefore, be too short if anoxic conditions apply. Because removal of microorganisms under suboxic conditions is unknown, this research investigated removal of bacteriophage MS2 and PRD1 by soil passage under suboxic conditions at field scale. At the field location (dune area), one injection well and six monitoring wells were installed at different depths along three suboxic flow lines, where oxygen concentrations ranged from 0.4 to 1.7 mg/l and nitrate concentrations ranged from 13 to 16 mg/L. PRD1 and MS2 were injected directly at the corresponding depths and their removal in each flow line was determined. The highest bacteriophage removal was observed in the top layer, with about 9 log removal of MS2, and 7 log removal of PRD1 after 16 meters of aquifer transport. Less removal was observed at 12 m below surface, probably due to a higher groundwater velocity in this coarser grained layer. MS2 was removed more effectively than PRD1 under all conditions. Due to short travel times, inactivation of the phages was limited and the reported log removal was mainly associated with attachment of phages to the aquifer matrix. This study shows that attachment of MS2 and PRD1 is similar for oxic and suboxic sandy aquifers, and, therefore, setback distances used for sandy aquifers under oxic and suboxic conditions provide a similar level of safety. Sticking efficiency and the attachment rate coefficient, as measures for virus attachment, were evaluated as a function of the physico-chemical conditions.
    • Travel-associated hepatitis A in Europe, 2009 to 2015.

      Beauté, Julien; Westrell, Therese; Schmid, Daniela; Müller, Luise; Epstein, Jevgenia; Kontio, Mia; Couturier, Elisabeth; Faber, Mirko; Mellou, Kassiani; Borg, Maria-Louise; et al. (2018-05)
      BackgroundTravel to countries with high or intermediate hepatitis A virus (HAV) endemicity is a risk factor for infection in residents of countries with low HAV endemicity. Aim: The objective of this study was to estimate the risk for hepatitis A among European travellers using surveillance and travel denominator data. Methods: We retrieved hepatitis A surveillance data from 13 European Union (EU)/ European Economic Area (EEA) countries with comprehensive surveillance systems and travel denominator data from the Statistical Office of the European Union. A travel-associated case of hepatitis A was defined as any case reported as imported. Results: From 2009 to 2015, the 13 countries reported 18,839 confirmed cases of hepatitis A, of which 5,233 (27.8%) were travel-associated. Of these, 39.8% were among children younger than 15 years. The overall risk associated with travel abroad decreased over the period at an annual rate of 3.7% (95% confidence interval (CI): 0.7-2.7) from 0.70 cases per million nights in 2009 to 0.51 in 2015. The highest risk was observed in travellers to Africa (2.11 cases per million nights). Cases more likely to be reported as travel-associated were male and of younger age (< 25 years). Conclusion: Travel is still a major risk factor for HAV infection in the EU/EEA, although the risk of infection may have slightly decreased in recent years. Children younger than 15 years accounted for a large proportion of cases and should be prioritised for vaccination.
    • Treatment correlates of successful outcomes in pulmonary multidrug-resistant tuberculosis: an individual patient data meta-analysis

      Ahmad, Nafees; Ahuja, Shama D; Akkerman, Onno W; Alffenaar, Jan-Willem C; Anderson, Laura F; Baghaei, Parvaneh; Bang, Didi; Barry, Pennan M; Bastos, Mayara L; Behera, Digamber; et al. (2018-09)
    • Treatment duration of febrile urinary tract infection: a pragmatic randomized, double-blind, placebo-controlled non-inferiority trial in men and women.

      van Nieuwkoop, Cees; van der Starre, Willize E; Stalenhoef, Janneke E; van Aartrijk, Anna M; van der Reijden, Tanny J K; Vollaard, Albert M; Delfos, Nathalie M; van 't Wout, Jan W; Blom, Jeanet W; Spelt, Ida C; et al. (2017-04-03)
      In adults with febrile urinary tract infection (fUTI), data on optimal treatment duration in patients other than non-pregnant women without comorbidities are lacking.
    • Treatment effectiveness of azithromycin and doxycycline in uncomplicated rectal and vaginal Chlamydia trachomatis infections in women: a multicentre observational study (FemCure).

      Dukers-Muijrers, Nicole H T M; Wolffs, Petra F G; Vries, Henry de; Götz, Hannelore M; Heijman, Titia; Bruisten, Sylvia; Eppings, Lisanne; Hogewoning, Arjan; Steenbakkers, Mieke; Lucchesi, Mayk; et al. (2019-01-28)
      Rectal infections with Chlamydia trachomatis (CT) are prevalent in women visiting a sexually transmitted infection (STI) outpatient clinic, but it remains unclear what the most effective treatment is. We assessed the effectiveness of doxycycline and azithromycin for the treatment of rectal and vaginal chlamydia in women. This study is part of a prospective multicentre cohort study (FemCure). Treatment consisted of doxycycline (100 mg twice daily for 7 days) in rectal CT positive women, and of azithromycin (1 g single dose) in vaginal positive women who were rectally untested or rectally negative. Participants self-collected rectal and vaginal samples at enrolment (treatment timepoint) and during 4 weeks of follow-up. The endpoint was microbiological cure by a negative nucleic acid amplification test at 4 weeks. Differences between cure proportions and 95% confidence intervals (CIs) were calculated. We analysed 416 patients of whom 319 had both rectal and vaginal chlamydia at enrolment, 22 had rectal chlamydia only, and 75 had vaginal chlamydia only. In 341 rectal infections, microbiological cure in azithromycin treated women was 78.5% (95%CI: 72.6 to 83.7, n=164/209) and 95.5% (95%CI: 91.0 to 98.2, n=126/132) in doxycycline treated women (difference 17.0%, 95%CI: 9.6 to 24.7, p<0.001). In 394 vaginal infections, cure was 93.5% (95%CI: 90.1 to 96.1,n=246/263) in azithromycin treated women and 95.4% (95%CI: 90.9 to 98.2,n=125/131) in doxycycline treated women (difference 1.9%, 95%CI: -3.6 to 6.7,p=0.504). The effectiveness of doxycycline is high and exceeds that of azithromycin for the treatment of rectal CT infections in women.
    • Trend analysis of air pollution and nitrogen deposition over the Netherlands using the EMEP4NL and OPS model.

      van der Swaluw, E; de Vries, W; Wichink Kruit, R; Aben, J; Vieno, M; Fagerli, H; Wind, P; van Pul, A (2019-12-12)
    • Trend analysis of reduced nitrogen components over the Netherlands with the EMEP4NL and OPS model.

      van der Swaluw, E; de Vries, W; Sauter, F; Wichink Kruit, R; Vieno, M; Fragerli, H; van Pul, A (2021-02-12)
    • Trends and correlates of antimicrobial use in broiler and turkey farms: a poultry company registry-based study in Italy.

      Caucci, Claudia; Di Martino, Guido; Dalla Costa, Alessandro; Santagiuliana, Manuel; Lorenzetto, Monica; Capello, Katia; Mughini-Gras, Lapo; Gavazzi, Luigi; Bonfanti, Lebana (2019-05-18)
    • Trends and determinants of antimicrobial susceptibility of Neisseria gonorrhoeae in the Netherlands, 2007 to 2015.

      Hofstraat, Sanne Hi; Götz, Hannelore M; van Dam, Alje P; van der Sande, Marianne Ab; van Benthem, Birgit Hb (2018-09)
      BackgroundNeisseria gonorrhoeae antibiotic resistance surveillance is important to maintain adequate treatment. We analysed 2007-15 data from the Gonococcal Resistance to Antimicrobials Surveillance (GRAS), which currently includes 19 of 25 sexually transmitted infection (STI) centres in the Netherlands. Methods: From each patient with a gonorrhoea culture, the minimum inhibitory concentration (MIC) for several antibiotics was determined. Time trends were assessed by geometric means and linear regression of logarithmic MIC. Determinants for decreased susceptibility to ceftriaxone (MIC > 0.032 mg/L) and resistance to cefotaxime (MIC > 0.125 mg/L) and azithromycin (MIC > 0.5 mg/L) were assessed using stratified logistic regression. Results: 11,768 isolates were analysed. No ceftriaxone resistance was found. In 2015, 27 of 1,425 isolates (1.9%) were resistant to cefotaxime and 176 of 1,623 (10.9%) to azithromycin. Ceftriaxone susceptibility showed no trend (p = 0.96) during the study period, but cefotaxime MIC decreased (p < 0.0001) and azithromycin MIC increased (p < 0.0001) significantly. Concerning ceftriaxone, isolates of men who have sex with men (MSM) from 2013 (p = 0.0005) and 2014 (p = 0.0004) were significantly associated with decreased susceptibility. Significant determinants for cefotaxime resistance were having ≥ 6 partners for women (p = 0.0006). For azithromycin,isolates from MSM collected in 2012 (p = 0.0035), 2013 (p = 0.012), and 2014 (p = 0.013), or from non-Dutch (p < 0.0001) or older (≥ 35 years; p = 0.01) MSM were significantly associated with susceptibility. Resistance in heterosexual men was significantly associated with being ≥ 25 years-old (p = 0.0049) or having 3-5 partners (p = 0.01). Conclusions: No ceftriaxone resistance was found, but azithromycin MIC increased in 2007-15. Resistance determinants could help with focused intervention strategies.
    • Trends en determinanten van resistentie van Neisseria gonorrhoeae in Nederland

      Hofstraat S; Benthem B van; Dam A van; Linde I (2016-06)
    • Trends in antimicrobial management of gonorrhoea by general practitioners in Amsterdam, the Netherlands, between 2010 and 2016: a cross-sectional study.

      van Amerongen, Roos; Gazendam, Roel P; van Bergen, Jan E A M (2019-01-15)
      Sexually transmitted infections (STI) caused by multidrug resistant Neisseria gonorrhoea are an emerging threat to global health. In the Netherlands, the general practitioner (GP) provides the major part of STI care. In 2013 an update of the Dutch guideline was published, recommending a single dose of intramuscular ceftriaxone as treatment for gonorrhoea infections. Data from a Dutch General Practitioner research database was used to investigate the guideline implementation for the treatment of gonorrhoea. A survey was conducted to gain more insight in GPs experiences with the recommended intramuscular therapy. Data on STI-related episodes and STI-diagnoses for gonorrhoea, based on ICPC codes were obtained from the electronic medical records (EMRs) from 35 GPs in Amsterdam for the years 2010 to 2016. Questionnaires regarding the treatment preferences were sent to GPs participating in the research network database. The number of gonorrhoea cases treated with first choice therapy increased from 81% in 2010 (intramuscular cefotaxime or ceftriaxone) to 93% in 2015 (only cefttriaxone). The number of ceftriaxone prescriptions increased substantially from 30% in 2010 to 93% in 2015. GPs preferred a single intramuscular shot of a third-generation cephalosporin above multiple oral doses of other antibiotics. The results demonstrate a successful shift in the antimicrobial management of gonorrhoea infections to ceftriaxone monotherapy according to the national guideline. GPs in this higher prevalence area in Amsterdam reported limited barriers in the intramuscular administration of third-generation cephalosporins.
    • Trends in governmental expenditure on vaccination programmes in the Netherlands, a historical analysis.

      van Wijhe, Maarten; de Boer, Pieter T; de Jong, Herman J; van Vliet, Hans; Wallinga, Jacco; Postma, Maarten J (2019-09-10)
    • Trends in human immunodeficiency virus diagnoses among men who have sex with men in North America, Western Europe, and Australia, 2000-2014.

      Chapin-Bardales, Johanna; Schmidt, Axel J; Guy, Rebecca J; Kaldor, John M; McGregor, Skye; Sasse, André; Archibald, Chris; Rank, Claudia; Casabona Barbarà, Jordi; Folch, Cinta; et al. (2018-12-01)
      The aim of the article was to investigate recent trends in human immunodeficiency virus (HIV) diagnosis rates among men who have sex with men (MSM) in high-income countries in North America, Western Europe, and Australia. Data on annual rates of HIV diagnoses among MSM aged 15 to 65 years from 2000 to 2014 were collected from 13 high-income countries. Joinpoint regression software was used to empirically determine country-specific trend periods. Trends in HIV diagnosis rates and in the proportion of diagnoses occurring in young MSM aged 15 to 24 years were analyzed using Poisson regression and log-binomial regression, respectively. Six countries experienced an increasing trend from 2000 to 2007-08 followed by either a stable or declining trend through 2014. Five countries had recently increasing trends, and two countries had one stable trend from 2000 to 2014. All 13 countries experienced increases in the proportion of diagnoses occurring in young MSM. Since 2008, half of the 13 high-income countries examined experienced stable or decreasing trends. Still, some countries continue to experience increasing HIV trends, and young MSM are increasingly represented among new diagnoses. Efforts to support early sexual health promotion, reduce barriers to pre-exposure prophylaxis, and improve care engagement for young MSM are critical to addressing current HIV trends.
    • Trends in prevalence of healthcare-associated infections and antimicrobial use in hospitals in the Netherlands: 10 years of national point-prevalence surveys.

      Hopmans, T E M; Smid, E A; Wille, J C; van der Kooi, T I I; Koek, M B G; Vos, M C; Geerlings, S E; de Greeff, S C (2019-10-15)
    • Trends in riverine element fluxes: A chronicle of regional socio-economic changes.

      Kopáček, Jiří; Hejzlar, Josef; Porcal, Petr; Posch, Maximilian (2017-11-15)
      We show how concentrations of water solutes in the Vltava River (Czech Republic) and their riverine outputs from the catchment were modified by socio-economic changes, land use, and hydrology between 1960 and 2015. In the early 1960s, HCO3 and Ca were the dominant ions. During 1960-1989 (a period of planned economy with an over-use of synthetic fertilizers, excessive draining of agricultural land and little environmental protection), the riverine concentrations of strong acid anions (SAAs: SO4, NO3, and Cl) increased 2-4-fold and their leaching was accompanied for by a 1.4-1.8-fold increase in concentrations of Ca, Mg, K, and Na. SAAs mostly originated from diffuse agricultural sources (synthetic fertilizers and mineralization of organic matter in freshly drained and deeply tilled agricultural land) and their annual average concentrations (as well as those of Ca, Mg, and K) were positively correlated with discharge. During 1990-2015 (a period of a re-established market economy, reduced fertilization, ceased drainage, partial conversion of arable land to pastures, and increasing environmental protection), concentrations of SO4 and NO3 significantly decreased due to reduced agricultural production and atmospheric pollution, and their positive correlations with discharge disappeared. In contrast, Na and Cl concentrations increased due to more intensive road de-icing, and their concentrations became negatively correlated with discharge. Trends in phosphorus concentrations reflected changes in its input by both diffuse (fertilizers) and point (wastewater) sources and were discharge independent.
    • Trends in Salmonella bij de mens, landbouwhuisdieren en in voedsel

      Broek I van den; Broek I van den; Broek I van den; Wit B; Heck M; Broek I van den (2016-10)
    • Trends in Salmonella in Nederland in 2016. Bij de mens, landbouwhuisdieren en in voedsel

      Broek I van den; Voort M van der; Broek I van den; Broek I van den; Wit B; de Melker HE; Broek I van den (2017-09-14)
    • Trends in socioeconomic disparities in stroke mortality in six european countries between 1981-1985 and 1991-1995.

      Avendaño, M; Kunst, A E; Lenthe, F van; Bos, V; Costa, G; Valkonen, T; Cardano, M; Harding, S; Borgan, J-K; Glickman, M; et al. (2005-01-01)
      This study assesses whether stroke mortality trends have been less favorable among lower than among higher socioeconomic groups. Longitudinal data on mortality by socioeconomic status were obtained for Finland, Norway, Denmark, Sweden, England/Wales, and Turin, Italy. Data covered the entire population or a representative sample. Stroke mortality rates were calculated for the period 1981-1995. Changes in stroke mortality rate ratios were analyzed using Poisson regression and compared with rate ratios in ischemic heat disease mortality. Trends in stroke mortality were generally as favorable among lower as among higher socioeconomic groups, such that socioeconomic disparities in stroke mortality persisted and remained of a similar magnitude in the 1990s as in the 1980s. In Norway, however, occupational disparities in stroke mortality significantly widened, and a nonsignificant increase was observed in some countries. In contrast, disparities in ischemic heart disease mortality widened throughout this period in most populations. Improvements in hypertension prevalence and treatment may have contributed to similar stroke mortality declines in all socioeconomic groups in most countries. Socioeconomic disparities in stroke mortality generally persisted and may have widened in some populations, which fact underlines the need to improve preventive and secondary care for stroke among the lower socioeconomic groups.