Cascade of care among hepatitis B patients in Maastricht, the Netherlands, 1996 to 2018.

Background & Aims: There are approximately 49,000 people (0.34%) in the Netherlands with a chronic hepatitis B virus (HBV) infection. It is unclear how many are linked to care and under follow-up in hepatitis outpatient clinics.

Timing of primary three-dose hepatitis B vaccination and postvaccination serologic testing among a large cohort of healthy adults.

This study evaluated the optimal timing of a primary three-dose hepatitis B vaccination and postvaccination serologic testing (PVST) among a large group of healthy naïve adults in the Netherlands. Data were collected from the Ease Travel Clinic hepatitis B vaccination database. The study population consisted of 22,997 adults who received three hepatitis B vaccinations.

Immunogenicity and safety of HBAI20 Hepatitis B vaccine in non-responders: Double-blinded, randomised, controlled phase 2 trial.

Background & Aims: Approximately 5%-10% of the general population respond inadequately to licensed recombinant hepatitis B vaccines. We assessed the immunogenicity and safety of a new HBAI20 vaccine, consisting of a new AI20 adjuvant (20-µg recombinant human IL-2 attached to 20-µg aluminium hydroxide) in combination with HBVaxPro®-10 µg.

Methods: In a double-blinded, randomised, controlled phase 2 trial, 18- to 59-year-old healthy non-responders (titre <10 mIU/ml after three or more doses of hepatitis B vaccine) were assigned (3:1 ratio) to receive either HBAI20 vaccine or HBVaxPro®-10 µg in a 0, 1 and 2-month schedule.

Serial measurements in COVID-19-induced acute respiratory disease to unravel heterogeneity of the disease course: design of the Maastricht Intensive Care COVID cohort (MaastrICCht).

Introduction: The course of the disease in SARS-CoV-2 infection in mechanically ventilated patients is unknown. To unravel the clinical heterogeneity of the SARS-CoV-2 infection in these patients, we designed the prospective observational Maastricht Intensive Care COVID cohort (MaastrICCht). We incorporated serial measurements that harbour aetiological, diagnostic and predictive information.

The effect of universal infant vaccination on the prevalence of hepatitis B immunity in adult solid organ transplant candidates.

Background: Hepatitis B virus (HBV) immunity is recommended to optimize outcomes after solid organ transplantation (SOT). This study assessed the prevalence and predictors of HBV immunity at the time patients were placed on transplant waiting list over a period from 1997 to 2019 in a low HBV endemic region.

Methods: Data were obtained from the University Hospitals Leuven transplant database.

CT in relation to RT-PCR in diagnosing COVID-19 in The Netherlands: A prospective study.

Introduction: Early differentiation between emergency department (ED) patients with and without corona virus disease (COVID-19) is very important. Chest CT scan may be helpful in early diagnosing of COVID-19. We investigated the diagnostic accuracy of CT using RT-PCR for SARS-CoV-2 as reference standard and investigated reasons for discordant results between the two tests.

Author Correction: Global phylogenetic analysis of Escherichia coli and plasmids carrying the mcr-1 gene indicates bacterial diversity but plasmid restriction.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Prevalence and risk factors for carriage of ESBL-producing Enterobacteriaceae in a population of Dutch travellers: A cross-sectional study.

Background: We investigated prevalence and predictive factors for ESBL-E carriage in a population of mostly travellers prior to their travel (n = 2216). In addition, we examined ESBL genotype before travel and compared these to returning travellers.

Method: A questionnaire and faecal sample were collected before travel, and a second faecal sample was collected immediately after travel.

Case report of delayed seroprotection rather than non-response after primary three-dose hepatitis B vaccination.

We describe a delayed hepatitis B seroprotection 12 weeks after the primary vaccination schedule in a 57-year-old male with smoldering multiple myeloma. Based on undetectable anti-HBs antibodies 6 weeks after the third vaccination, the index person was previously considered to be a hepatitis B vaccine non-responder. Because hepatitis B vaccination started in the 1980s, many hepatitis B vaccine non-responders have received a revaccination regimen.

Ethnicity and response to primary three-dose hepatitis B vaccination in employees in the Netherlands, 1983 through 2017.

Background And Aims: Hepatitis B virus (HBV) vaccination is recommended to all employees who have an occupational risk in the Netherlands. This study assessed the determinants of the immune response to primary standard three-dose HBV vaccination (0, 1, 6 months), with the main focus on ethnicity.

Methods: Out of 76 239 individuals who received HBV vaccination between April 1983 and December 2017, 11 567 persons with a known country of birth and complete vaccination schedule were included in this study.

Invasive Aspergillosis Mimicking Metastatic Lung Cancer.

In a patient with a medical history of cancer, the most probable diagnosis of an FDG-avid pulmonary mass combined with intracranial abnormalities on brain imaging is metastasized cancer. However, sometimes a differential diagnosis with an infectious cause such as aspergillosis can be very challenging as both cancer and infection are sometimes difficult to distinguish. Pulmonary aspergillosis can present as an infectious pseudotumour with clinical and imaging characteristics mimicking lung cancer.

Global phylogenetic analysis of Escherichia coli and plasmids carrying the mcr-1 gene indicates bacterial diversity but plasmid restriction.

To understand the dynamics behind the worldwide spread of the mcr-1 gene, we determined the population structure of Escherichia coli and of mobile genetic elements (MGEs) carrying the mcr-1 gene. After a systematic review of the literature we included 65 E. coli whole genome sequences (WGS), adding 6 recently sequenced travel related isolates, and 312 MLST profiles.

Travel-related acquisition of diarrhoeagenic bacteria, enteral viruses and parasites in a prospective cohort of 98 Dutch travellers.

Background: Limited prospective data are available on the acquisition of viral, bacterial and parasitic diarrhoeagenic agents by healthy individuals during travel.

Methods: To determine the frequency of travel associated acquisition of 19 pathogens in 98 intercontinental travellers, qPCR was used to detect 8 viral pathogens, 6 bacterial enteric pathogens and 5 parasite species in faecal samples collected immediately before and after travel.

Results: We found high pre-travel carriage rates of Blastocystis spp.

Acute Kidney Injury After Efavirenz/Tenofovir Disoproxil Fumarate/Emtricitabine (Atripla) Overdose.

We describe a patient with acute renal failure and irreversible kidney damage after an overdose with the fixed dose combination of efavirenz/tenofovir disoproxil fumarate/emtricitabine (Atripla). The acute kidney injury was most probably caused by tenofovir. Efavirenz and emtricitabine seemed relatively safe in overdose.

Detection of the plasmid-mediated colistin-resistance gene mcr-1 in faecal metagenomes of Dutch travellers.

Background: Recently, the first plasmid-mediated colistin-resistance gene, mcr-1, was reported. Colistin is increasingly used as an antibiotic of last resort for the treatment of infections caused by carbapenem-resistant bacteria, which have been rapidly disseminating worldwide in recent years.

Objectives: The reported carriage rate of mcr-1 in humans remains sporadic thus far, except for those reported in Chinese populations.

Prolonged carriage and potential onward transmission of carbapenemase-producing Enterobacteriaceae in Dutch travelers.

Aim: The aim was to study acquisition and persistence of carbapenemase-producing Enterobacteriaceae (CPE) among travelers.

Materials & Methods: Stools from 2001 travelers and 215 nontraveling household members, collected before and immediately post-travel as well as 1, 3, 6 and 12 months upon return, were screened for CPE.

Results: Five travelers, all visiting Asia outside the Indian subcontinent, acquired CPE.

Diagnosis and management of aspergillosis in the Netherlands: a national survey.

A survey of diagnosis and treatment of invasive aspergillosis was conducted in eight University Medical Centers (UMCs) and eight non-academic teaching hospitals in the Netherlands. Against a background of emerging azole resistance in Aspergillus fumigatus routine resistance screening of clinical isolates was performed primarily in the UMCs. Azole resistance rates at the hospital level varied between 5% and 10%, although rates up to 30% were reported in high-risk wards.

Risk stratification by abbMEDS and CURB-65 in relation to treatment and clinical disposition of the septic patient at the emergency department: a cohort study.

Background: Sepsis leads to high mortality, therefore risk stratification is important. The abbMEDS (abbreviated Mortality Emergency Department Sepsis) score assesses sepsis severity and predicts mortality. In community-acquired pneumonia, the CURB-65 (Confusion, Urea, Respiration, Blood pressure, Age) also provides support in clinical decisions regarding antibiotic treatment and clinical disposition.

High rates of antimicrobial drug resistance gene acquisition after international travel, The Netherlands.

We investigated the effect of international travel on the gut resistome of 122 healthy travelers from the Netherlands by using a targeted metagenomic approach. Our results confirm high acquisition rates of the extended-spectrum β-lactamase encoding gene blaCTX-M, documenting a rise in prevalence from 9.0% before travel to 33.

Improving sexual health for HIV patients by providing a combination of integrated public health and hospital care services; a one-group pre- and post test intervention comparison.

Background: Hospital HIV care and public sexual health care (a Sexual Health Care Centre) services were integrated to provide sexual health counselling and sexually transmitted infections (STIs) testing and treatment (sexual health care) to larger numbers of HIV patients. Services, need and usage were assessed using a patient perspective, which is a key factor for the success of service integration.

Methods: The study design was a one-group pre-test and post-test comparison of 447 HIV-infected heterosexual individuals and men who have sex with men (MSM) attending a hospital-based HIV centre serving the southern region of the Netherlands.

The first locally acquired human infection of Echinococcus multilocularis in The Netherlands.

In the northern part of Western Europe, Echinococcus multilocularis is primarily detected in and spreading among foxes. The present case marks E. multilocularis as an emerging pathogen for humans, as it describes the first human case of probably locally acquired E.