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Be.well.pro: Monitoring the work-related well-being of professionals from the health care and social care sectors in Belgium
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Impact of the 2020 EUCAST ‘I’ definition on the treatment of Pseudomonas aeruginosa infections: A national multicentric observational study in Belgian hospitals. 33rd International Congress of Antimicrobia
No full textImpact of the 2020 EUCAST « I » definition on the treatment of Pseudomonas aeruginosa infections: a national multicentric observational study inBelgian hospitals
Laura Bonacini1, Boudewijn Catry1,2, Lucy Catteau1,3
1 Department of Epidemiology and public health, Sciensano, Brussels, Belgium.
2 Faculty of Medicine, Université libre de Bruxelles, Bruxelles, Belgium.
3 Department of Epidemiology and public health, Sciensano, Brussels, Belgium, Faculty of Medicine and Pharmacy, Université de Mons, Mons, Belgium.
AIM: To examine the impact of revisions by the European Committee on Antimicrobial Susceptibility Testing (EUCAST) on antibiotic selection for treating Pseudomonas aeruginosan infections in Belgian hospitals.
BACKGROUND: In 2020, EUCAST redefined the ‘I’ category in antimicrobial susceptibility testing to ‘susceptible, increased exposure,’ aiming to optimize antibiotic therapy byadvocating targeted narrow-spectrum antibiotics at higher doses, rather than broader spectrum antibiotics at standard doses. By July 2022, Belgian labs were encouraged to adopt thesechanges, categorizing most antipseudomonal drugs as ‘I’ while retaining broad-spectrum antibiotics as ‘S’.
METHODS: Between November 2023 and May 2024, all Belgian hospitals were invited to participate in a voluntary multicentric retrospective observational study. Data were collectedusing a Redcap tool, focusing on hospitalized adults treated for wild-type
Pseudomonas aeruginosa infections during a six-month period pre- and post-implementation of the newEUCAST definitions. Collected data included epidemiological, microbiological, clinical, and antimicrobial therapy details. The primary outcome assessed was the frequency ofmeropenem prescriptions following susceptibility testing.
RESULTS: The study included 1705 patients (850 pre- and 855 post-implementation) from 38 hospitals (37% nationwide participation). Meropenem prescription significantly increasedpost-EUCAST update, rising from 4.6% (39/850) pre-implementation to 7.1% (6⅛55) post-implementation. This increase was observed in 47% (18/38) of the participating hospitals.
CONCLUSIONS: The 2020 EUCAST criteria implementation led to a significant increase in meropenem prescriptions for P. aeruginosa infections. This underscores the need for furtherresearch into prescribing practices and reinforces the importance of prescriber education and antibiotic stewardship programs.</p
The future burden of type 2 diabetes in Belgium: a microsimulation model.
No full textOBJECTIVE: To forecast the annual burden of type 2 diabetes and related socio-demographic disparities in Belgium until 2030.
METHODS: This study utilized a discrete-event transition microsimulation model. A synthetic population was created using 2018 national register data of the Belgian population aged 0-80 years, along with the national representative prevalence of diabetes risk factors obtained from the latest (2018) Belgian Health Interview and Examination Surveys using Multiple Imputation by Chained Equations (MICE) as inputs to the Simulation of Synthetic Complex Data (simPop) model. Mortality information was obtained from the Belgian vital statistics and used to calculate annual death probabilities. From 2018 to 2030, synthetic individuals transitioned annually from health to death, with or without developing type 2 diabetes, as predicted by the Finnish Diabetes Risk Score, and risk factors were updated via strata-specific transition probabilities.
RESULTS: A total of 6722 [95% UI 3421, 11,583] new cases of type 2 diabetes per 100,000 inhabitants are expected between 2018 and 2030 in Belgium, representing a 32.8% and 19.3% increase in T2D prevalence rate and DALYs rate, respectively. While T2D burden remained highest for lower-education subgroups across all three Belgian regions, the highest increases in incidence and prevalence rates by 2030 are observed for women in general, and particularly among Flemish women reporting higher-education levels with a 114.5% and 44.6% increase in prevalence and DALYs rates, respectively. Existing age- and education-related inequalities will remain apparent in 2030 across all three regions.
CONCLUSIONS: The projected increase in the burden of T2D in Belgium highlights the urgent need for primary and secondary preventive strategies. While emphasis should be placed on the lower-education groups, it is also crucial to reinforce strategies for people of higher socioeconomic status as the burden of T2D is expected to increase significantly in this population segment.</p
Investigation of the presence of PFAS in household vegetables grown in the Flanders region
No full textAn interlaboratory proficiency test using metagenomic sequencing as a diagnostic tool for the detection of RNA viruses in swine fecal material.
No full textUNLABELLED: Metagenomic shotgun sequencing (mNGS) can serve as a generic molecular diagnostic tool. An mNGS proficiency test (PT) was performed in six European veterinary and public health laboratories to detect porcine astroviruses in fecal material and the extracted RNA. While different mNGS workflows for the generation of mNGS data were used in the different laboratories, the bioinformatic analysis was standardized using a metagenomic read classifier as well as read mapping to selected astroviral reference genomes to assess the semiquantitative representation of astrovirus species mixtures. All participants successfully identified and classified most of the viral reads to the two dominant species. The normalized read counts obtained by aligning reads to astrovirus reference genomes by Bowtie2 were in line with Kraken read classification counts. Moreover, participants performed well in terms of repeatability when the fecal sample was tested in duplicate. However, the normalized read counts per detected astrovirus species differed substantially between participants, which was related to the different laboratory methods used for data generation. Further modeling of the mNGS data indicated the importance of selecting appropriate reference data for mNGS read classification. As virus- or sample-specific biases may apply, caution is needed when extrapolating this swine feces-based PT for the detection of other RNA viruses or using different sample types. The suitability of experimental design to a given pathogen/sample matrix combination, quality assurance, interpretation, and follow-up investigation remain critical factors for the diagnostic interpretation of mNGS results.
IMPORTANCE: Metagenomic shotgun sequencing (mNGS) is a generic molecular diagnostic method, involving laboratory preparation of samples, sequencing, bioinformatic analysis of millions of short sequences, and interpretation of the results. In this paper, we investigated the performance of mNGS on the detection of porcine astroviruses, a model for RNA viruses in a pig fecal material, among six European veterinary and public health laboratories. We showed that different methods for data generation affect mNGS performance among participants and that the selection of reference genomes is crucial for read classification. Follow-up investigation remains a critical factor for the diagnostic interpretation of mNGS results. The paper contributes to potential improvements of mNGS as a diagnostic tool in clinical settings.</p
Students day - Initiative for Quality improvement and Epidemiology among Children and Adolescents with Diabetes (IQECAD)
No full textIntroduction to the IQECAD project (Initiative for Quality improvement and Epidemiology among Children and Adolescents with Diabetes ) during the Students day organized by Sciensano on 03/05/2024</p
