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La lutte globale contre les inégalités en santé, au prisme de la solidarité européenne, l’exemple des maladies rares
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Quality indicators for infection prevention and control in acute care hospitals - Supplement report 2024
No full textUsing priorities between human and livestock bacterial antimicrobial resistance (AMR) to identify data gaps in livestock AMR surveillance
No full textBackground
Bacterial antimicrobial resistance (AMR) is a global threat to both humans and livestock. Despite this, there is limited global consensus on data-informed, priority areas for intervention in both sectors. We compare current livestock AMR data collection efforts with other variables pertinent to human and livestock AMR to identify critical data gaps and mutual priorities.
Methods
We globally synthesized livestock AMR data from open-source surveillance reports and point prevalence surveys stratified for six pathogens (Escherichia coli, Staphylococcus aureus, non-typhoidal Salmonella, Campylobacter spp., Enterococcus faecalis, Enterococcus faecium) and eleven antimicrobial classes important in human and veterinary use, published between 2000 and 2020. We also included all livestock species represented in the data: cattle, chickens, pigs, sheep, turkeys, ducks, horses, buffaloes, and goats. We compared this data with intended priorities calculated from: disability-adjusted life years (DALYs), livestock antimicrobial usage (AMU), livestock biomass, and a global correlation exercise between livestock and human proportion of resistant isolates.
Results
Resistance to fluoroquinolones and macrolides in Staphylococcus aureus were identified as priorities in many countries but, less than 10% of these reported livestock AMR data. Resistance data for Escherichia coli specific to cattle, chickens, and pigs, which we prioritized, were also well collected. AMR data collection on non-typhoidal Salmonella and other livestock species were often not prioritized. Of 232 categories prioritized by at least one country, data were only collected for 48% (n = 112).
Conclusions
The lack of livestock AMR data globally for broad resistance in Staphylococcus aureus could underplay their zoonotic threat. Countries can bolster livestock AMR data collection, reporting, and intervention setting for Staphylococcus aureus as done for Escherichia coli. This framework can provide guidance on areas to strengthen AMR surveillance and decision-making for humans and livestock, and if done routinely, can adapt to resistance trends and priorities.</p
Accuracy of immunological tests on serum and urine for diagnosis of Taenia solium neurocysticercosis: A systematic review
No full textBackground
Taenia solium neurocysticercosis is a zoonotic neglected tropical disease, for which adequate diagnostic management is paramount, especially in patients with active cysts for whom improved and timely management could prove beneficial. Immunodiagnosis can potentially partially mitigate the necessity for neuroimaging, shortening the diagnostic -and treatment- pathway. An up-to-date review of immunological test performance is however lacking.
Methodology/Principal findings
Searches were performed in PubMed, EMBASE, Web of Science, and Scopus (up to January 2024), with included records fitting the review scope, i.e. accuracy evaluation of an antibody-/or antigen-detecting immunological test, using serum or urine of humans confirmed via reference standard (i.e. neuroimaging or surgery/biopsy). Record data was assessed, with classification of descriptive data on cyst localization and stage according to a developed confidence scale, and with selection of tests evaluated on a sufficiently high sample size. A QUADAS-2 risk of bias assessment was performed. After screening, 169 records were included for data collection, with 53 records—corresponding to 123 tests- selected for analysis. Absence of data and large data heterogeneity complicated result interpretation. The lentil lectin-bound glycoprotein enzyme-linked immunoelectrotranfser blot seems to fulfill high accuracy standards regarding detection of parenchymal active multiple cysts; also antigen-detecting tests on serum and urine performed well, additionally in detection of extraparenchymal neurocysticercosis. A novel multi-antigen print immunoassay is highly promising, with sensitivity for detection of extraparenchymal and parenchymal active single and multiple cysts of 100.0%, and specificity of 98.5%. Point-of-care tests showed promising results, however require further evaluation in targeted resource-poor settings.
Conclusions/Significance
The review highlights the importance of transparent and unambiguous data reporting. With promising immunological tests in development, the challenge before usage in targeted settings will be to perform large-scale evaluations whilst holding into account both optimized test performance and ease of use. Accessibility to validated tests and feasibility of implementation should also be considered.</p
Projet BIOSOL (Biomonitoring humain et Sols contaminés): Synthèse scientifique du volet « Santé Humaine».
No full textEpidemiologische surveillance van invasieve pneumokokkeninfecties (IPD) - 2023
No full text• Geconjugeerde pneumokokkenvaccins werden geïntroduceerd in het kindervaccinatie programma in België in 2007. Initieel werd gevaccineerd met PCV7, gevolgd door PCV13 vanaf 2011, waarna men een daling in invasieve infecties waarnam over alle leeftijden, met name bij kinderen jonger dan 2 jaar.
• Nadat PCV13 vervangen werd door PCV10 in 2015/2016 steeg de incidentie opnieuw, vooral door PCV13-exclusieve serotypes en in 2019 werd daarom terug naar PCV13 overgeschakeld, het vaccin dat tot op heden in het basisvaccinatieschema opgenomen is.
• Na de COVID-19 pandemie, waarbij een sterke daling in IPD gevallen werd waargenomen, zien we opnieuw een sterke stijging in aantal gevallen, met 1746 gevallen gerapporteerd door het NRC in 2023.
• Het aantal infecties met PCV13-serotypes is terug afgenomen bij kinderen jonger dan 2 jaar, maar er is sprake van serotype-vervanging waarbij het aandeel van serotypes niet vervat in het vaccin, toeneemt.
• Bij de oudere populatie stijgt de incidentie tot boven het niveau van voor de COVID-19 pandemie, voornamelijk door PCV20-serotypes. PCV20 wordt sinds 2022 als eerste keuze aangeraden voor vaccinatie van deze populatie.</p
Exposure assessment of perfluoroalkyl substances as follow-up on the concerns raised in the recent opinion of EFSA
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Possible impact of culture-independent diagnostic techniques on surveillance of gastrointestinal pathogens in Belgium
No full textCulture-independent diagnostic techniques (CIDT) are increasingly used to detect gastrointestinal pathogens as they offer short turnaround times, high sensitivities and specificities, and ultimately improve patient care. However, the absence of clinical isolates may hamper epidemiological investigations and public health surveillance. In Belgium, CIDT for gastrointestinal pathogens are not widely used yet, but a change in the reimbursement conditions might affect laboratory practices.
In the context of the project United 4 Surveillance, whose main objective is to strengthen surveillance of infectious diseases in Europe, we carried out an online survey in April 2024 among medical laboratories in Belgium. The aim was to (i) estimate current diagnostic practices, (ii) assess future diagnostic practices in light of the upcoming change in test reimbursement and (iii) estimate the interest of laboratories for public health questions for Salmonella, Shigella, Yersinia, STEC and Campylobacter.
The participation rate was 80% (90/113). For STEC, up to 55% of the laboratories are currently using CIDT with an increase to 85% when CIDT will be added to the reimbursement conditions. For the other four pathogens, 75 to 95% of the laboratories currently perform culture, but a change in diagnostic practice towards CIDT is foreseen (55-70%) when included in the reimbursement scheme. More than 80% of the laboratories intend to perform reflex cultures or send samples to the national reference centers.
A switch in diagnostic practices towards CIDT for gastrointestinal pathogens is expected but there is a strong intention of the laboratories to participate to surveillance activities. The impact of this change will be monitored closely to maintain a comprehensive view on circulating strains for public health surveillance.</p