Description of a nationwide structure for monitoring nosocomial outbreaks of (highly resistant) microorganisms in the Netherlands : characteristics of outbreaks in 2012-2021
© 2023. The Author(s)..
BACKGROUND: Before 2012, established national surveillance systems in the Netherlands were not able to provide a timely, comprehensive epidemiological view on nosocomial outbreaks. The Healthcare-associated Infections and AntiMicrobial Resistance Monitoring Group (SO-ZI/AMR) was initiated in 2012 for timely national nosocomial outbreak monitoring and risk assessment. This paper aims to describe the achievements of the SO-ZI/AMR by presenting characteristics of outbreaks reported in 2012-2021.
METHODS: Hospitals and, since 2015, long-term care facilities (LTCF) were requested to report outbreaks when (1) continuity of care was threatened, or (2) transmission continued despite control measures. A multi-disciplinary expert panel (re-)assessed the public health risk of outbreaks during monthly meetings, using 5 severity phases and based on data collected via standardised questionnaires. We descriptively studied the panel's consensus-based severity classification, distribution of (highly resistant) microorganisms, and duration and size of outbreaks between April 2012 and December 2021.
RESULTS: In total, 353 hospital outbreaks and 110 LTCF outbreaks were reported. Most outbreaks (hospitals: n = 309 (88%), LTCF: n = 103 (94%)) did not progress beyond phase 1 (no public health implications, outbreak expected to be controlled within two months), one hospital outbreak reached phase 4 (insufficient/ineffective response: possible public health threat, support offered). Highly resistant microorganisms (HRMO) were involved in 269 (76%) hospital and 103 (94%) LTCF outbreaks. Most outbreaks were caused by methicillin-resistant Staphylococcus aureus (MRSA; n = 93 (26%) in hospitals, n = 80 (72%) in LTCF), vancomycin-resistant Enterococcus faecium (VRE; n = 116 (33%) in hospitals, n = 2 (2%) in LTCF) and highly resistant Enterobacterales (n = 41 (12%) in hospitals, n = 20 (18%) in LTCF). Carbapenemase-producing gram-negative bacteria were involved in 32 (9.1%) hospital and five (4.5%) LTCF outbreaks. In hospitals, VRE outbreaks had the longest duration (median 2.3; range 0.0-22.8 months) and widest range of affected patients (median 9; range 2-483).
CONCLUSIONS: The SO-ZI/AMR provided national insight into the characteristics of nosocomial outbreaks over the past decade. HRMO outbreaks - mostly caused by MRSA, VRE (in hospitals) and highly resistant Enterobacterales - occurred regularly, but most of them were controlled quickly and did not develop into a public health threat. The SO-ZI/AMR has become a solid monitoring body, essential to assess risks and raise awareness of potential HRMO threats.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:12 |
|---|---|
| Enthalten in: |
Antimicrobial resistance and infection control - 12(2023), 1 vom: 08. Dez., Seite 143 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Woudt, Sjoukje Hs [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Epidemiology |
|---|
| Anmerkungen: |
Date Completed 16.12.2023 Date Revised 22.02.2024 published: Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1186/s13756-023-01350-9 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM36557399X |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM36557399X | ||
| 003 | DE-627 | ||
| 005 | 20240222232155.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1186/s13756-023-01350-9 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1302.xml |
| 035 | |a (DE-627)NLM36557399X | ||
| 035 | |a (NLM)38066583 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Woudt, Sjoukje Hs |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Description of a nationwide structure for monitoring nosocomial outbreaks of (highly resistant) microorganisms in the Netherlands |b characteristics of outbreaks in 2012-2021 |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 16.12.2023 | ||
| 500 | |a Date Revised 22.02.2024 | ||
| 500 | |a published: Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023. The Author(s). | ||
| 520 | |a BACKGROUND: Before 2012, established national surveillance systems in the Netherlands were not able to provide a timely, comprehensive epidemiological view on nosocomial outbreaks. The Healthcare-associated Infections and AntiMicrobial Resistance Monitoring Group (SO-ZI/AMR) was initiated in 2012 for timely national nosocomial outbreak monitoring and risk assessment. This paper aims to describe the achievements of the SO-ZI/AMR by presenting characteristics of outbreaks reported in 2012-2021 | ||
| 520 | |a METHODS: Hospitals and, since 2015, long-term care facilities (LTCF) were requested to report outbreaks when (1) continuity of care was threatened, or (2) transmission continued despite control measures. A multi-disciplinary expert panel (re-)assessed the public health risk of outbreaks during monthly meetings, using 5 severity phases and based on data collected via standardised questionnaires. We descriptively studied the panel's consensus-based severity classification, distribution of (highly resistant) microorganisms, and duration and size of outbreaks between April 2012 and December 2021 | ||
| 520 | |a RESULTS: In total, 353 hospital outbreaks and 110 LTCF outbreaks were reported. Most outbreaks (hospitals: n = 309 (88%), LTCF: n = 103 (94%)) did not progress beyond phase 1 (no public health implications, outbreak expected to be controlled within two months), one hospital outbreak reached phase 4 (insufficient/ineffective response: possible public health threat, support offered). Highly resistant microorganisms (HRMO) were involved in 269 (76%) hospital and 103 (94%) LTCF outbreaks. Most outbreaks were caused by methicillin-resistant Staphylococcus aureus (MRSA; n = 93 (26%) in hospitals, n = 80 (72%) in LTCF), vancomycin-resistant Enterococcus faecium (VRE; n = 116 (33%) in hospitals, n = 2 (2%) in LTCF) and highly resistant Enterobacterales (n = 41 (12%) in hospitals, n = 20 (18%) in LTCF). Carbapenemase-producing gram-negative bacteria were involved in 32 (9.1%) hospital and five (4.5%) LTCF outbreaks. In hospitals, VRE outbreaks had the longest duration (median 2.3; range 0.0-22.8 months) and widest range of affected patients (median 9; range 2-483) | ||
| 520 | |a CONCLUSIONS: The SO-ZI/AMR provided national insight into the characteristics of nosocomial outbreaks over the past decade. HRMO outbreaks - mostly caused by MRSA, VRE (in hospitals) and highly resistant Enterobacterales - occurred regularly, but most of them were controlled quickly and did not develop into a public health threat. The SO-ZI/AMR has become a solid monitoring body, essential to assess risks and raise awareness of potential HRMO threats | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Epidemiology | |
| 650 | 4 | |a Infection control | |
| 650 | 4 | |a Multidrug resistance | |
| 650 | 4 | |a Nosocomial infections | |
| 650 | 4 | |a Outbreaks | |
| 650 | 4 | |a Surveillance | |
| 700 | 1 | |a Schoffelen, Annelot F |e verfasserin |4 aut | |
| 700 | 1 | |a Frakking, Florine Nj |e verfasserin |4 aut | |
| 700 | 1 | |a Reuland, E Ascelijn |e verfasserin |4 aut | |
| 700 | 1 | |a Severin, Juliëtte A |e verfasserin |4 aut | |
| 700 | 1 | |a den Drijver, Marije |e verfasserin |4 aut | |
| 700 | 1 | |a Haenen, Anja |e verfasserin |4 aut | |
| 700 | 1 | |a Nonneman, Marga Mg |e verfasserin |4 aut | |
| 700 | 1 | |a Notermans, Daan W |e verfasserin |4 aut | |
| 700 | 1 | |a Aan de Stegge, Desiree Cm |e verfasserin |4 aut | |
| 700 | 1 | |a de Stoppelaar, Sacha F |e verfasserin |4 aut | |
| 700 | 1 | |a Vandenbroucke-Grauls, Christina Mje |e verfasserin |4 aut | |
| 700 | 1 | |a de Greeff, Sabine C |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Antimicrobial resistance and infection control |d 2012 |g 12(2023), 1 vom: 08. Dez., Seite 143 |w (DE-627)NLM220841640 |x 2047-2994 |7 nnns |
| 773 | 1 | 8 | |g volume:12 |g year:2023 |g number:1 |g day:08 |g month:12 |g pages:143 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1186/s13756-023-01350-9 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 12 |j 2023 |e 1 |b 08 |c 12 |h 143 | ||