Screening for Clostridioides difficile colonization at admission to the hospital: a multi-centre study.

Objectives: To assess the value of screening for Clostridioides difficile colonization (CDC) at hospital admission in an endemic setting.

Methods: A multi-centre study was conducted at four hospitals located across the Netherlands. Newly admitted patients were screened for CDC.

[How to diagnose infective endocarditis?].

We report on three patients with infective endocarditis, which differ greatly in clinical manifestations. Infective endocarditis (IE) is defined by, a mostly bacterial, infection of a native or prosthetic heart valve, the endocardial surface or a cardiac device. It is a rare condition, but it's incidence is increasing because of an increased incidence of elderly patients with chronic disease and cardiac devices.

Whipple's endocarditis: a case report of a blood culture-negative endocarditis.

Background: Whipple's disease is caused by and causes a self-limiting gastrointestinal infection. The majority of the population is an asymptomatic carrier, however, in some patients, it causes an invasive infection with for example arthritis, endocarditis, or involvement of the eyes.

Case Summary: This case describes a man with long-lasting complaints of progressive dyspnoea caused by heart failure due to total destruction of the aortic and mitral valve as a result of endocarditis, diagnosed with serum polymerase chain reaction.

[Antibiotic therapy in dental practice].

Dentists and dental surgeons very frequently prescribe antibiotics to their patients. In a small percentage of cases, that is appropriate; however, patients can often also heal without antibiotic therapy. Microbiological analysis is only carried out in a very limited number of cases, and is complex and time-consuming.

Successful Debridement of a Knee Joint Prosthesis Infected with . Case Report and Review of Current Literature.

According to the relevant literature, prosthetic joint infections caused by require two stage revision surgery or prosthesis removal for a successful outcome. We present the case of a patient who suffered such an infection after Total Knee Replacement surgery and was successfully treated with antibiotics, joint lavage, debridement and retention of the prosthesis.

Sepsis caused by acute phlegmonous gastritis based on a group A .

We present a case of 45-year-old male with acute phlegmonous gastritis (APG) based on a hemolytic group A APG is a rare and often a potentially fatal disease, which is characterized by a severe bacterial infection of the gastric wall. Because APG is a rapidly progressive disease, it comes with high mortality rates. Patients with an early diagnosis may undergo successful treatment and have a survival benefit.

Human resources required for antimicrobial stewardship teams: a Dutch consensus report.

Scope: Antimicrobial stewardship teams are responsible for implementing antimicrobial stewardship programmes (ASP). However, in many countries, lack of funding challenges this obligation. A consensus procedure was performed to investigate which structural activities need to be performed by Dutch stewardship teams and how much time (and thus full-time equivalent (FTE) labor) is needed to perform these activities.

Nucleic Acid Amplification Test Quantitation as Predictor of Toxin Presence in Clostridium difficile Infection.

Multistep algorithmic testing in which a sensitive nucleic acid amplification test (NAAT) is followed by a specific toxin A and toxin B enzyme immunoassay (EIA) is among the most accurate methods for infection (CDI) diagnosis. The obvious shortcoming of this approach is that multiple tests must be performed to establish a CDI diagnosis, which may delay treatment. Therefore, we sought to determine whether a preliminary diagnosis could be made on the basis of the quantitative results of the first test in algorithmic testing, which provide a measure of organism burden.

Detection of Clostridium difficile in Feces of Asymptomatic Patients Admitted to the Hospital.

Recent evidence shows that patients asymptomatically colonized with Clostridium difficile may contribute to the transmission of C. difficile in health care facilities. Additionally, these patients may have a higher risk of developing C.

[A blood culture containing coagulase-negative staphylococci: not always due to contamination].

Staphylococcus lugdunensis (SL) is a species belonging to the group of coagulase-negative staphylococci (CNS). It can cause severe infections such as endocarditis. Three cases of endocarditis caused by SL are presented.

Current evidence on hospital antimicrobial stewardship objectives: a systematic review and meta-analysis.

Background: Antimicrobial stewardship is advocated to improve the quality of antimicrobial use. We did a systematic review and meta-analysis to assess whether antimicrobial stewardship objectives had any effects in hospitals and long-term care facilities on four predefined patients' outcomes: clinical outcomes, adverse events, costs, and bacterial resistance rates.

Methods: We identified 14 stewardship objectives and did a separate systematic search for articles relating to each one in Embase, Ovid MEDLINE, and PubMed.

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.

Coccidioidomycosis infection of a total knee arthroplasty in a nonendemic region.

Fungal prosthetic joint infections are rare and difficult to treat. There is an ongoing discussion about the type and duration of antifungal treatment and the necessity of prosthesis removal. We report the first European case of an infected total knee arthroplasty with Coccidioides immitis.

Case report: tick-borne encephalitis in two Dutch travellers returning from Austria, Netherlands, July and August 2011.

Tick-borne encephalitis (TBE) is not endemic in the Netherlands and diagnostics are seldom requested. Here, we report about the rare event of TBE in two Dutch travellers returning from Austria in July and August 2011. This report serves to create awareness among physicians to consider travel-related TBE in their differential diagnosis of patients with neurological disease returning from TBE virus endemic regions and to promote awareness among professionals advising travellers.

The use of Raman spectroscopy in the epidemiology of methicillin-resistant Staphylococcus aureus of human- and animal-related clonal lineages.

In order to perform a cost-effective search and destroy policy for methicillin-resistant Staphylococcus aureus (MRSA), a quick and reliable typing method is essential. In an area with a high level of animal-related MRSA ST398, pulsed field gel electrophoresis (PFGE) typing and spa-typing are not sufficient to discriminate between co-incidental findings and true transmission of MRSA. This study is the first to retrospectively show the performance of Raman spectroscopy in 16 well-documented outbreaks.

Infection and colonization with methicillin resistant Staphylococcus aureus ST398 versus other MRSA in an area with a high density of pig farms.

The purpose of this study was to evaluate the impact of the emergence of animal related methicillin resistant Staphylococcus aureus ST398 in an area with a high density of pig farms. A retrospective analysis was performed of all MRSA isolates in the laboratory database from 2002 till 2008 including typing results and clinical data from infection control archives and patient charts. The implementation of the screening of people in contact with pigs and veal calves for MRSA led to an increase in the average number of newly identified carriers from 16 per year between July 2002 and July 2006 to 148 between July 2006 and December 2008.

[Invasive pneumococcal infection in 5 newborns, 1996-2004].

At the Máxima Medisch Centrum in Veldhoven, The Netherlands, neonatal sepsis caused by invasive Streptococcus pneumoniae infection was diagnosed in 5 neonates between 1996 and 2004. This infection is relatively rare and its clinical features are variable, but often particularly severe and fulminant as was the case in 2 of the 5 children, one of whom died and the other was left with serious psychomotor retardation. The other 3 recovered fully.

High-throughput amplification fragment length polymorphism (htAFLP) analysis identifies genetic lineage markers but not complement phenotype-specific markers in Moraxella catarrhalis.

Comparative high-throughput amplified fragment length polymorphism (htAFLP) analysis was performed on a set of 25 complement-resistant and 23 complement-sensitive isolates of Moraxella catarrhalis in order to determine whether there were complement phenotype-specific markers within this species. The htAFLP analysis used 21 primer-pair combinations, generating 41 364 individual fragments and 2273 fragment length polymorphisms, with an average of 862 polymorphisms per isolate. Analysis of polymorphism data clearly indicated the presence of two phylogenetic lineages and 40 (2%) lineage-specific polymorphisms.

Moraxella catarrhalis is only a weak activator of the mannose-binding lectin (MBL) pathway of complement activation.

A hemolytic bystander assay was used to assess the functional serum mannose-binding lectin (MBL) activating capacity of five isolates of Moraxella catarrhalis obtained from children who suffered recurrent acute otitis media episodes. Results showed that this organism is only a poor activator of the lectin pathway of complement activation, with subsequent consequences for the etiology of otitis media by this organism.

A novel plasmid (pEMCJH03) isolated from moraxella catarrhalis possibly useful as a cloning and expression vector within this species.

A preliminary screening study of six Moraxella catarrhalis isolates from primary school children in the Netherlands identified a small 3.5 kb plasmid (pEMCJH03), containing four open reading frames, which encoded three mobilizing and one replicase protein. Insertion of a kanamycin containing transposon (yielding pEMCJH04) allowed selection and isolation of the plasmid in Escherichia coli.

Changes in genetic types and population dynamics of Moraxella catarrhalis in hospitalized children are not associated with an exacerbation of existing disease.

Pulsed-field gel electrophoresis typing was performed on a retrospective set of 129 Moraxella catarrhalis isolates obtained over a 20 month period from 70 children admitted to, or presenting at, the Erasmus University Medical Center, Rotterdam, The Netherlands. The mean age of the children (at the end of the study) was 2.5 years, with a range of 6 months to 15 years.

Severity of nonbullous Staphylococcus aureus impetigo in children is associated with strains harboring genetic markers for exfoliative toxin B, Panton-Valentine leukocidin, and the multidrug resistance plasmid pSK41.

Nonbullous impetigo is a common skin infection in children and is frequently caused by Staphylococcus aureus. Staphylococcal toxins and especially exfoliative toxin A are known mediators of bullous impetigo in children. It is not known whether this is also true for nonbullous impetigo.

A case of Mycoplasma hominis meningo-encephalitis in a full-term infant: rapid recovery after start of treatment with ciprofloxacin.

Unlabelled: The role of Mycoplasma hominisas a causative agent for neonatal sepsis and meningitis is still unclear. Meningitis secondary to M. hominisis well-described in the literature; however, M.