1. |
- Soes, L. M., et al.
(author)
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The incidence and clinical symptomatology of Clostridium difficile infections in a community setting in a cohort of Danish patients attending general practice
- 2014
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In: European Journal of Clinical Microbiology & Infectious Diseases. - : Springer Science and Business Media LLC. - 1435-4373 .- 0934-9723. ; 33:6, s. 957-967
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Journal article (peer-reviewed)abstract
- Clostridium difficile infection (CDI) is gradually being recognised as a cause of morbidity in the community. We investigated the incidence and clinical characteristics of CDI in a community setting and characterised the C. difficile strains by toxin gene profiling and polymerase chain reaction (PCR) ribotyping. Patients included in the study had attended general practice, primarily because of diarrhoea; CDI patients (259 patients; 121 < 2 years of age) had positive cultures for toxigenic C. difficile and non-CDI patients (455 patients) were culture-negative. Outcome variables included the frequency and duration of diarrhoea, vomiting, stomach ache, fever > 38 A degrees C, weight loss and sick leave. Data were analysed by logistic regression. CDI patients < 2 and a parts per thousand yen2 years of age with C. difficile as the only enteropathogen in the faecal sample reported slimy stools (65 % vs. 62 %), stomach ache (60 % vs. 75 %), weight loss (50 % vs. 76 %) and duration of diarrhoea > 15 days (59 % vs. 73 %) as the predominant symptoms. CDI patients a parts per thousand yen2 years old reported duration of diarrhoea > 15 days more often compared to non-CDI patients (73 % vs. 27 %, p < 0.0001). The annual incidence of CDI was 518 and 23/100,000 for patients < 2 and a parts per thousand yen2 years of age, respectively, and 46/100,000 in the subgroup of patients a parts per thousand yen60 years of age. CDI was characterised by stomach ache and persistent diarrhoea, often leading to weight loss. This emphasises the importance of diagnosing CDI not only in hospitalised patients, but also in individuals a parts per thousand yen2 years of age attending general practice because of gastrointestinal symptoms, especially in the elderly, where the incidence of CDI is high.
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2. |
- Lindstedt, B A, et al.
(author)
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Use of multilocus variable-number tandem repeat analysis (MLVA) in eight European countries, 2012
- 2013
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In: Eurosurveillance. - : European Centre for Disease Prevention and Control. - 1025-496X .- 1560-7917. ; 18:4
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Journal article (peer-reviewed)abstract
- Genotyping of important medical or veterinary prokaryotes has become a very important tool during the last decades. Rapid development of fragment-separation and sequencing technologies has made many new genotyping strategies possible. Among these new methods is multilocus variable-number tandem repeat analysis (MLVA). Here we present an update on the use of MLVA in eight European countries (Denmark, France, Germany, Ireland, Italy, the Netherlands, Norway and Sweden). Researchers in Europe have been active in developing and implementing a large array of different assays. MLVA has been used as a typing tool in several contexts, from aiding in resolving outbreaks of foodborne bacteria to typing organisms that may pose a bioterrorist threat, as well as in scientific studies.
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3. |
- de Knegt, Leonardo V., et al.
(author)
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Application of Molecular Typing Results in Source Attribution Models : The Case of Multiple Locus Variable Number Tandem Repeat Analysis (MLVA) of Salmonella Isolates Obtained from Integrated Surveillance in Denmark
- 2016
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In: Risk Analysis. - : Wiley. - 0272-4332 .- 1539-6924. ; 36:3, s. 571-588
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Journal article (peer-reviewed)abstract
- Salmonella is an important cause of bacterial foodborne infections in Denmark. To identify the main animal-food sources of human salmonellosis, risk managers have relied on a routine application of a microbial subtyping-based source attribution model since 1995. In 2013, multiple locus variable number tandem repeat analysis (MLVA) substituted phage typing as the subtyping method for surveillance of S. Enteritidis and S. Typhimurium isolated from animals, food, and humans in Denmark. The purpose of this study was to develop a modeling approach applying a combination of serovars, MLVA types, and antibiotic resistance profiles for the Salmonella source attribution, and assess the utility of the results for the food safety decisionmakers. Full and simplified MLVA schemes from surveillance data were tested, and model fit and consistency of results were assessed using statistical measures. We conclude that loci schemes STTR5/STTR10/STTR3 for S. Typhimurium and SE9/SE5/SE2/SE1/SE3 for S. Enteritidis can be used in microbial subtyping-based source attribution models. Based on the results, we discuss that an adjustment of the discriminatory level of the subtyping method applied often will be required to fit the purpose of the study and the available data. The issues discussed are also considered highly relevant when applying, e.g., extended multi-locus sequence typing or next-generation sequencing techniques.
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4. |
- Mateva, Gergana, et al.
(author)
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Genetic polymorphism and antimicrobial resistance of Salmonellaenterica serovar Enteritidis isolates from veterinary and food sourcesin Bulgaria
- 2019
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Conference paper (other academic/artistic)abstract
- Background:Salmonellosis is one of the most frequent food-borne infections. It iscaused by contaminated food mainly of animal origin, although humanto human transmission and numerous environmental contaminationsmay also be inflicted. Between 30 and 60% of the reported food-borneoutbreaks in the EU are caused by Salmonella and this is the secondmost commonly reported food-borne infection causing gastroenteritis.Salmonella enterica serovar Enteritidis (S. Enteritidis) is the mostwidespread serovar in Europe and other parts of the world.Methods:In this study we analysed forty-nine S. Enteritidis isolates from veterinaryand food sources in Bulgaria obtained during the period of eight years.We used multiple-locus variable-number of tandem repeats analysis(MLVA) genotyping and the classical antimicrobial resistance (AMR) discdiffusion method to test the diversity of the isolates.Results:Results showed that isolates were divided into twenty-four MLVA andnine AMR profiles. The calculated Simpsons diversity index was 0.956for MLVA and 0.754 for AMR, respectively. The AMR testing revealed that47% of the isolates were resistant to one and 4% to ≥4 antimicrobials.The most frequent resistotypes were resistance to sulphonamides (n=21)and sensitive to all compounds (n=9). The most frequent MLVA profileswere 3-5-3-3-11 (n=6); 5-13-2-3-11 (n=5); 5-9-2-3-8 (n=5); 6-12-2-3-11(n=4); 5-10-2-3-11 (n=3); 4-5-3-3-9 (n=3). MLVA profiles are presentedaccording to the order of the loci sequenced: SE1, SE2, SE9, SE3 and SE5.We searched for similar S. Enteritidis MLVA profiles in published data. Apartial match was found for some profiles only.Conclusions:It could be concluded that the MLVA profiles of S. Enteritidis obtained inthis study (the first ones for Bulgaria) have not been frequently isolatedin other counties.
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5. |
- Tast Lahti, Elina, et al.
(author)
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One Health surveillance : A cross-sectoral detection, characterization, and notification of foodborne pathogens
- 2023
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In: Frontiers In Public Health. - : Frontiers Media S.A.. - 2296-2565. ; 11
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Journal article (peer-reviewed)abstract
- IntroductionSeveral Proficiency Test (PT) or External Quality Assessment (EQA) schemes are currently available for assessing the ability of laboratories to detect and characterize enteropathogenic bacteria, but they are usually targeting one sector, covering either public health, food safety or animal health. In addition to sector-specific PTs/EQAs for detection, cross-sectoral panels would be useful for assessment of the capacity to detect and characterize foodborne pathogens in a One Health (OH) perspective and further improving food safety and interpretation of cross-sectoral surveillance data. The aims of the study were to assess the cross-sectoral capability of European public health, animal health and food safety laboratories to detect, characterize and notify findings of the foodborne pathogens Campylobacter spp., Salmonella spp. and Yersinia enterocolitica, and to develop recommendations for future cross-sectoral PTs and EQAs within OH. The PT/EQA scheme developed within this study consisted of a test panel of five samples, designed to represent a theoretical outbreak scenario. MethodsA total of 15 laboratories from animal health, public health and food safety sectors were enrolled in eight countries: Denmark, France, Italy, the Netherlands, Poland, Spain, Sweden, and the United Kingdom. The laboratories analyzed the samples according to the methods used in the laboratory and reported the target organisms at species level, and if applicable, serovar for Salmonella and bioserotype for Yersinia. ResultsAll 15 laboratories analyzed the samples for Salmonella, 13 for Campylobacter and 11 for Yersinia. Analytical errors were predominately false negative results. One sample (S. Stockholm and Y. enterocolitica O:3/BT4) with lower concentrations of target organisms was especially challenging, resulting in six out of seven false negative results. These findings were associated with laboratories using smaller sample sizes and not using enrichment methods. Detection of Salmonella was most commonly mandatory to notify within the three sectors in the eight countries participating in the pilot whereas findings of Campylobacter and Y. enterocolitica were notifiable from human samples, but less commonly from animal and food samples. DiscussionThe results of the pilot PT/EQA conducted in this study confirmed the possibility to apply a cross-sectoral approach for assessment of the joint OH capacity to detect and characterize foodborne pathogens.
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