Publications by authors named "Willemsen I"

Article Synopsis
  • - The study explored the prevalence of drug-resistant bacteria in children at daycare centers (DCCs) in The Netherlands and Belgium, finding notable differences in the rates of antimicrobial resistant bacteria like ESBL-E and CipR-E between the two countries.
  • - Data was collected from 28 Dutch and 18 Belgian DCCs through stool samples and parental questionnaires, assessing various hygiene practices and identifying factors that may influence the presence of these resistant bacteria.
  • - Results indicated that the prevalence of ESBL-E was higher in Belgium (16%) compared to the Netherlands (6%), and children travelling to Asia or using antimicrobials were at greater risk, while proper cleaning practices could reduce risks of CipR-E.
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The sporadic nature of DUX4 expression in FSHD muscle challenges comparative transcriptome analyses between FSHD and control samples. A variety of DUX4 and FSHD-associated transcriptional changes have been identified, but bulk RNA-seq strategies prohibit comprehensive analysis of their spatiotemporal relation, interdependence and role in the disease process. In this study, we used single-nucleus RNA-sequencing of nuclei isolated from patient- and control-derived multinucleated primary myotubes to investigate the cellular heterogeneity in FSHD.

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Facioscapulohumeral muscular dystrophy (FSHD) is caused by the epigenetic derepression of the 4q-linked D4Z4 macrosatellite repeat resulting in inappropriate expression of the D4Z4 repeat-encoded DUX4 gene in skeletal muscle. In 5% of FSHD cases, D4Z4 chromatin relaxation is due to germline mutations in one of the chromatin modifiers SMCHD1, DNMT3B or LRIF1. The mechanism of SMCHD1- and LRIF1-mediated D4Z4 repression is not clear.

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Background: Inpatient quality indicators (IQIs) were previously developed to assess responsible antibiotic use.

Aim: Practice testing of these QIs in the hospital setting.

Method: This study was performed within a Dutch-Belgian border network of hospitals implementing the Infection Risk Scan (IRIS) point prevalence survey (PPS) as part of the i-4-1-Health project.

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Article Synopsis
  • A new tool called the Infection Risk Scan (IRIS) has been developed to evaluate infection control and antimicrobial use across various hospitals.
  • The implementation of IRIS involved standardized measurements, such as patient comorbidities and hand hygiene performance, and was executed by trained local infection control practitioners in nine hospitals along the Dutch/Belgian border.
  • Results showed significant differences in infection control metrics between hospitals in Belgium and the Netherlands, highlighting areas for potential improvement in quality of care.
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Structural Maintenance of Chromosomes Hinge Domain Containing 1 (SMCHD1) is a chromatin repressor, which is mutated in > 95% of Facioscapulohumeral dystrophy (FSHD) type 2 cases. In FSHD2, SMCHD1 mutations ultimately result in the presence of the cleavage stage transcription factor DUX4 in muscle cells due to a failure in epigenetic repression of the D4Z4 macrosatellite repeat on chromosome 4q, which contains the DUX4 locus. While binding of SMCHD1 to D4Z4 and its necessity to maintain a repressive D4Z4 chromatin structure in somatic cells are well documented, it is unclear how SMCHD1 is recruited to D4Z4, and how it exerts its repressive properties on chromatin.

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Design: A two-phase prospective intervention study.

Objective: The objective of this study was to determine if feedback of adenosine triphosphate (ATP) measurements decreases environmental contamination within hospitals in the Dutch/Belgian border area.

Methods: Standardized ATP measurements were conducted in nine hospitals on pre-defined fomites.

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Background: The objective of this study was to determine the correlation between adenosine triphosphate (ATP) measurements and microbial contamination using a standardized method. Secondarily, analyzing reproducibility of ATP measurements and aerobic colony counts (ACC's) on the same surface.

Methods: ATP measurements and ACC's were conducted on 10 pre-defined fomites in a hospital and nursing home setting.

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Background: The objective of this study was to determine the level of environmental contamination in hospitals in the Dutch/Belgian border area, using ATP measurements.

Design: A cross-sectional observational survey.

Methods: Standardized ATP measurements were conducted in 9 hospitals on 32 hospital wards.

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Retail chicken meat is a potential source of extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E). In the past decade, vast national efforts were undertaken to decrease the antibiotic use in the veterinary sector, resulting in a 58% decrease in antibiotic sales in the sector between 2009 and 2014. This decrease in antibiotic use was followed by a decrease in ESBL-E prevalence in broilers.

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Background: The infection risk scan (IRIS) is a tool to measure the quality of infection control (IC) and antimicrobial use in a standardized way. We describe the feasilibility of the IRIS in a Dutch hospital (the Netherlands, NL) and a hospital in the United States (US).

Methods: Cross-sectional measurements were performed.

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Background: Facioscapulohumeral dystrophy (FSHD) is associated with partial chromatin relaxation of the retrogene containing D4Z4 macrosatellite repeats on chromosome 4, and transcriptional de-repression of in skeletal muscle. The common form of FSHD, FSHD1, is caused by a D4Z4 repeat array contraction. The less common form, FSHD2, is generally caused by heterozygous variants in .

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Article Synopsis
  • The study aimed to assess the prevalence and risk factors associated with multidrug-resistant organisms (MDRO), specifically extended spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E), in 12 long-term care facilities (LTCFs) in Amsterdam from November 2014 to August 2015.
  • Fecal and nasal samples were collected from 385 residents, finding an overall prevalence of 18.2% for multidrug-resistant Gram-negative bacteria and 14.5% for ESBL-E specifically, with the majority of ESBL-E cases linked to CTX-M production.
  • The research indicated that 80% of residents with ESBL-E were not previously identified as carriers, highlighting significant undetected
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Article Synopsis
  • The study examined how environmental factors affect the survival of Enterobacteriaceae bacteria, identifying a need for more research in this area.
  • The researchers created a new in vitro model to measure bacterial survival over time using two specific strains of ESBL-producing bacteria.
  • Results showed that bacteria could survive for up to 70 days, with a significant initial drop in viable counts followed by a slower decline, and ST131 strain exhibited better survival rates, especially in sheep blood.
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Objective: The objective of this study is to determine the prevalence of rectal carriage of plasmid- and chromosome-encoded AmpC β-lactamase-producing Escherichia coli and Klebsiella spp. in patients in a Dutch teaching hospital between 2013 and 2016.

Methods: Between 2013 and 2016, hospital-wide yearly prevalence surveys were performed to determine the prevalence of AmpC β-lactamase-producing E.

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Community-acquired carriage and infections due to extended-spectrum beta-lactamase producing Enterobacteriaceae (ESBL-E) are increasing worldwide, resulting in increased morbidity, mortality and healthcare costs. The origins of community-acquired ESBL-E carriage and infections remain unclear. Bean sprouts are a potential source of Enterobacteriaceae for the community, as illustrated by outbreaks of pathogenic Enterobacteriaceae in the past.

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Background: Infection control needs user-friendly standardized instruments to measure the compliance to guidelines and to implement targeted improvement actions. This abstract describes a tool to measure the quality of infection control and antimicrobial use, the Infection Risk Scan (IRIS). It has been applied in a hospital, several nursing homes and a rehabilitation clinic in the Netherlands.

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Article Synopsis
  • 8.5% of patients using proton pump inhibitors (PPIs) were found to be rectal carriers of extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E), significantly higher than the 2.9% in non-PPI users.
  • Statistical analysis indicated a strong link, with PPI use associated with nearly four times the odds of carrying ESBL-E at hospital admission.
  • The study's findings suggest that PPI usage may increase the risk of carrying these antibiotic-resistant bacteria.
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Objective: The increase in Highly Resistant Micro-Organisms (HRMO) in hospitals and nursing homes requires an intensification of infection prevention measures. This paper describes a new, standardised approach to infection prevention and monitoring of antibiotic use.

Design: Cross-sectional, observational study.

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This paper describes the trends in prevalence of ESBL producing Enterobacteriaceae (ESBL-E) and ESBL genes, measured in five consecutive yearly Point Prevalence Surveys (PPS). All patients present in the hospital and in a day-care clinic (including patients on dialysis) on the day of the survey, were screened for perianal ESBL-E carriage. Perianal swabs were taken and cultured using an enrichment broth and a selective agar plate.

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Introduction: The laboratory detection of OXA-48-carbapenemase-producing Enterobacteriaceae is difficult, as minimum inhibition concentrations for carbapenems are often below the clinical breakpoint. In 2011, the Dutch national guideline for the detection of highly resistant micro-organisms was issued, which includes recommendations on the use of carbapenem screening breakpoints for the detection of carbapenemase-producing Enterobacteriaceae.

Materials And Methods: During a validation study of the Check-MDR CT103 microarray (Check-Points, Wageningen, The Netherlands) in 2013, an OXA-48-like carbapenemase gen was identified in two isolates that were previously obtained from a patient with non-Hodgkin lymphoma in 2007.

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Article Synopsis
  • Investigated risk factors for the rectal carriage and transmission of ESBL-producing Enterobacteriaceae (ESBL-E) in a nursing home outbreak.
  • Conducted a cross-sectional survey of 189 residents, finding a 20.6% ESBL-E positivity rate among 160 screened individuals, with significant variation in rates between wards.
  • Revealed extensive clonal spread of a specific E. coli strain (bla CTX-M1-15 positive ST131) across multiple wards, highlighting the need for improved understanding of future risks and transmission routes in nursing homes.
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Background: We developed a standardised method to assess the quality of infection control in Dutch Nursing Home (NH), based on a cross-sectional survey that visualises the results. The method was called the Infection control RIsk Infection Scan (IRIS). We tested the applicability of this new tool in a multicentre surveillance executed June and July 2012.

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Next-generation sequencing (NGS) has the potential to provide typing results and detect resistance genes in a single assay, thus guiding timely treatment decisions and allowing rapid tracking of transmission of resistant clones. We evaluated the performance of a new NGS assay (Hospital Acquired Infection BioDetection System; Pathogenica) during an outbreak of sequence type 131 (ST131) Escherichia coli infections in a nursing home in The Netherlands. The assay was performed on 56 extended-spectrum-beta-lactamase (ESBL) E.

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Objectives: The aim of this study was to compare the current screening methods and to evaluate confirmation tests for phenotypic plasmidal AmpC (pAmpC) detection.

Methods: For this evaluation we used 503 Enterobacteriaceae from 18 Dutch hospitals and 21 isolates previously confirmed to be pAmpC positive. All isolates were divided into three groups: isolates with 1) reduced susceptibility to ceftazidime and/or cefotaxime; 2) reduced susceptibility to cefoxitin; 3) reduced susceptibility to ceftazidime and/or cefotaxime combined with reduced susceptibility to cefoxitin.

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