Publications by authors named "Witteveen S"

The management of head and neck melanoma (HNM) is constantly being fine-tuned in the era of immunotherapy. HNM have different metastatic patterns and a worse prognosis than melanoma of the trunk, asking for a more fine-tuned managing strategy. In clinically node-negative HNM patients, the ultrasound (US) with fine needle aspiration cytology (FNAC) and chest X-ray (CXR) are optional modalities in the preoperative staging workup.

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  • Multidrug-resistant organisms (MDRO) are a major public health concern, and understanding their genomic characteristics is vital for monitoring and controlling infections.
  • This study focuses on the use of long-read whole-genome sequencing (WGS) to analyze the molecular profiles of 356 MDRO isolates, including various bacteria such as Klebsiella pneumoniae and methicillin-resistant Staphylococcus aureus (MRSA).
  • Results showed that long-read sequencing provides comparable molecular data to short-read sequencing, with high consistency in multi-locus sequence typing (wgMLST) profiles, though some differences were noted in Pseudomonas aeruginosa.
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  • A study in Romania revealed a growing prevalence of New Delhi metallo-beta-lactamase (NDM)-producing Enterobacterales in hospitals, with 355 cases reported from 2018 to 2022.
  • Analysis of 74 isolates over nearly two years identified four persistent multi-hospital clusters of these drug-resistant bacteria, demonstrating sustained transmission across multiple regions.
  • The findings highlight the urgent need for enhanced infection control measures and improved national surveillance for carbapenem-resistant pathogens in healthcare systems across the EU/EEA.
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  • A significant rise in multidrug-resistant microorganisms (MDRO) was noted following the transfer of Ukrainian patients to hospitals, with various resistant strains identified, including carbapenem-resistant bacteria.
  • Testing for antimicrobial susceptibility showed low efficacy rates for several last-resort antibiotics, highlighting severe resistance issues among these pathogens.
  • Factors influencing cefiderocol susceptibility results include testing methods and standards used, making understanding resistance patterns crucial for treating patients suspected of Gram-negative infections with recent hospitalizations in Ukraine.
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BackgroundThe war in Ukraine led to migration of Ukrainian people. Early 2022, several European national surveillance systems detected multidrug-resistant (MDR) bacteria related to Ukrainian patients.AimTo investigate the genomic epidemiology of New Delhi metallo-β-lactamase (NDM)-producing from Ukrainian patients among European countries.

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During 2015-2022, a genetic cluster of OXA-48-producing uropathogenic Escherichia coli sequence type 127 spread throughout the Netherlands. The 20 isolates we investigated originated mainly from urine, belonged to Clermont phylotype B2, and carried 18 genes encoding putative uropathogenicity factors. The isolates were susceptible to first-choice antimicrobial drugs for urinary tract infections.

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Background: Although the Netherlands is a country with a low endemic level, methicillin-resistant Staphylococcus aureus (MRSA) poses a significant health care problem. Therefore, high coverage national MRSA surveillance has been in place since 1989. To monitor possible changes in the type-distribution and emergence of resistance and virulence, MRSA isolates are molecularly characterized.

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Objectives: MRSA carrying the mecC gene (mecC-MRSA) have been found in humans and animals worldwide. A high carriage rate of mecC-MRSA has been described among hedgehogs in different countries. We performed genomic comparison of mecC-MRSA from hedgehogs and humans using next-generation sequencing (NGS) to investigate possible zoonotic transmission in the Netherlands.

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Since March 2022, there has been an emergence of multidrug-resistant organisms (MDRO) in the Netherlands in patients originating from Ukraine (58 patients, 75 isolates). For about half of these patients, recent hospitalisation in Ukraine was reported. Genomic surveillance revealed that the majority of the MDRO represent globally spread epidemic lineages and that 60% contain New Delhi metallo-β-lactamase (NDM) genes.

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In this retrospective observational study, we analysed a community outbreak of impetigo with meticillin-resistant (MRSA), with additional resistance to fusidic acid (first-line treatment). The outbreak occurred between June 2018 and January 2020 in the eastern part of the Netherlands with an epidemiological link to three cases from the north-western part. Forty nine impetigo cases and eight carrier cases were identified, including 47 children.

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Objectives: While Livestock-associated methicillin-resistant (LA-MRSA), defined as CC398, is a well-known pathogen among those working with livestock, there are indications that LA-MRSA prevalence among the general population is increasing. However, the clinical impact in urban areas remains unknown. The aim of this study was to assess the genetic epidemiology and clinical characteristics of LA-MRSA in an urban area with a limited livestock population.

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Background: Although the Netherlands is a country with a low endemic level of methicillin-resistant (MRSA), a national MRSA surveillance has been in place since 1989. In 2003 livestock emerged as a major reservoir of MRSA and currently livestock-associated MRSA (clonal complex CC398) make up 25% of all surveillance isolates. To assess possible transfer of resistant strains or resistance genes, MRSA obtained from humans and animals were characterized in detail.

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Staphylococcus argenteus is a recently described member of the Staphylococcus aureus complex (SAC) and is associated with human disease. The frequency and intensity of infections caused by are similar to those of Staphylococcus aureus. can harbor antibiotic resistance genes and a variety of virulence factors analogous to methicillin-resistant S.

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  • * A study involving 22 Dutch laboratories analyzed 72 pairs of colistin-resistant (COLR-EK) and colistin-susceptible (COLS-EK) bacterial isolates, revealing that 21% of COLR-EK patients had previously received colistin treatment.
  • * While colistin resistance remains relatively rare in the Netherlands, some isolates showed genetic mutations linked to resistance, highlighting a need for ongoing monitoring and testing practices.
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Verona Integron-encoded Metallo-beta-lactamase (VIM) is the most frequently-encountered carbapenemase in the healthcare-related pathogen Pseudomonas aeruginosa. In the Netherlands, a low-endemic country for antibiotic-resistant bacteria, no national surveillance data on the prevalence of carbapenemase-producing P. aeruginosa (CPPA) was available.

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Background: Carbapenemases produced by Enterobacterales are often encoded by genes on transferable plasmids and represent a major healthcare problem, especially if the plasmids contain additional antibiotic resistance genes. As part of Dutch national surveillance, 50 medical microbiological laboratories submit their Enterobacterales isolates suspected of carbapenemase production to the National Institute for Public Health and the Environment for characterization. All isolates for which carbapenemase production is confirmed are subjected to next-generation sequencing.

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Carbapenem-hydrolysing enzymes belonging to the OXA-48-like group are encoded by -like alleles and are abundant among in the Netherlands. Therefore, the objective here was to investigate the characteristics, gene content and diversity of the -like carrying plasmids and chromosomes of and collected in the Dutch national surveillance from 2014 to 2019 in comparison with genome sequences from 29 countries. A combination of short-read genome sequencing with long-read sequencing enabled the reconstruction of 47 and 132 complete -like plasmids for and , respectively.

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  • Carbapenemase-producing Klebsiella pneumoniae has become a significant hospital-acquired pathogen, leading to increased illness and death, necessitating close monitoring of its spread and genetic diversity among patients.
  • The study aimed to analyze and track the genetic makeup of K. pneumoniae strains with a specific beta-lactamase gene (bla) in the Netherlands and former Dutch Caribbean islands from 2014 to 2019 using advanced sequencing techniques.
  • Findings revealed distinct genetic clusters and variations in plasmids, indicating different antibiotic resistance and virulence characteristics, particularly highlighting the transmission of a specific strain (KpnCluster-019 bla) between regions.
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Objectives: Carbapenem resistance mediated by mobile genetic elements has emerged worldwide and has become a major public health threat. To gain insight into the molecular epidemiology of carbapenem resistance in The Netherlands, Dutch medical microbiology laboratories are requested to submit suspected carbapenemase-producing Enterobacterales (CPE) to the National Institute for Public Health and the Environment as part of a national surveillance system.

Methods: Meropenem MICs and species identification were confirmed by E-test and MALDI-TOF and carbapenemase production was assessed by the Carbapenem Inactivation Method.

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  • Resistance to methicillin in certain bacteria is mainly due to a gene found on a mobile genetic element called the staphylococcal cassette chromosome (SCC), which plays a key role in the emergence of methicillin-resistant strains (MRSA).
  • A 2012 outbreak involved a health care worker and three patients infected with fusidic acid-resistant MRSA, prompting the investigation into the genetic makeup of the strains involved.
  • Genomic analysis revealed that the methicillin-susceptible strain (MSSA) had likely acquired the SCC from MRSA, leading to its ability to cause an outbreak, supported by close genetic similarities between the isolates.
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