Eurosurveillance最新文献

{"title":"<i>Klebsiella aerogenes</i> ST117 causing folliculitis in men having sex with men, Belgium, February 2025.","authors":"Nicolas Yin, Jonathan Krygier, Célestin Mairesse, Agnès Libois, Sophie Quoilin, Delphine Martiny","doi":"10.2807/1560-7917.ES.2025.30.20.2500304","DOIUrl":"10.2807/1560-7917.ES.2025.30.20.2500304","url":null,"abstract":"<p><p><i>Klebsiella aerogenes</i> has recently been reported as a causative agent of folliculitis in men who have sex with men (MSM). We present four cases of folliculitis in MSM diagnosed in Brussels, Belgium. Patients were aged between 25 and 50 years, and all were infected by a single multilocus sequence type (ST117) strain. This strain carried the yersiniabactin siderophore genes. Following a preliminary treatment by sulfamethoxazole-trimethoprim for 7-14 days, all patients experienced a recurrence of symptoms, necessitating an extended therapeutic regimen.</p>","PeriodicalId":12161,"journal":{"name":"Eurosurveillance","volume":"30 20","pages":""},"PeriodicalIF":9.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105092/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the editor: Absence of cross-reactivity of the cobas WNV assay with human pegiviruses.","authors":"Paula Saá, Ke Chen, Ellen Ordinario","doi":"10.2807/1560-7917.ES.2025.30.21.2500316","DOIUrl":"10.2807/1560-7917.ES.2025.30.21.2500316","url":null,"abstract":"","PeriodicalId":12161,"journal":{"name":"Eurosurveillance","volume":"30 21","pages":""},"PeriodicalIF":9.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12124113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute flaccid myelitis in Europe between 2016 and 2023: indicating the need for better registration.","authors":"Jelte Helfferich, Cristina Calvo, Ekkehardt Alpeter, Cristina Andrés, Andrés Antón, Melodie Aubart, Stefania Maria Bova, Maria Cabrerizo, Karin von Eije, Stollar Fabiola, Ana Felipe, Ralitsa Iordanova, Marianne Kragh Thomsen, Per Kristian Knudsen, Freek van Loenen, Noemi Lopez, Audrey Mirand, Richard Molenkamp, Sofie Midgley, Raquel Neves, Lubomira Nikolaeva Glomb, Joakim Øverbø, Gülten Öztürk, Paula Palminha, Helle Cecilie Viekilde Pfeiffer, Birgit Prochazka, Carlos Ribeiro, Martine Rodesch, Isabelle Schuffenecker, Jay Shetty, Sandy Siegert, Silje Lae Solberg, Artur Sulik, Dilşad Türkdoğan, Olcay Ünver, Jaco Verweij, Jorgina Vila, Tytti Vuorinen, Ronny Wickström, Thea K Fischer, Heli Harvala, Kimberley S M Benschop","doi":"10.2807/1560-7917.ES.2025.30.21.2400579","DOIUrl":"10.2807/1560-7917.ES.2025.30.21.2400579","url":null,"abstract":"<p><p>BackgroundAcute flaccid myelitis (AFM) is a rare polio-like condition affecting mainly children and characterised by severe, often persistent, weakness. It is one of several causes of acute flaccid paralysis (AFP), which manifests as acute onset of limb weakness and reduced muscle tone. Some non-polio enteroviruses (EV), such as EV-D68 may cause AFM. Little is known about AFM incidence in Europe.AimWe aimed to better understand AFM incidence, aetiology and current surveillance policies in Europe.MethodsIn 28 countries, members of the European non-polio enterovirus network (ENPEN) and a newly established AFM network of clinicians under ENPEN received a survey asking them how AFM surveillance was performed in their countries in 2016-2023 and the numbers of AFM cases including those diagnosed with EV-D68 infection during this period.ResultsSurveillance information was obtained for 16 countries. In eight countries, AFP surveillance initiated for poliomyelitis eradication was still ongoing, while non-polio AFM cases were only systematically reported in Norway. The survey revealed 130 AFM cases for 14 countries, with 48 (37%) EV-D68-laboratory-confirmed. Among the AFM cases, 70% (n = 91) occurred in 2016, 2018 and 2022, when EV-D68 circulation increased.ConclusionsThis report provides some indication of AFM case numbers in Europe since 2016. However, as 15 of 16 countries with AFM monitoring information lacked structural AFM surveillance, numbers should be interpreted with caution. Knowing AFM incidence matters to determine its impact and detect future outbreaks. Thus, the newly established clinical network will develop a European AFM repository.</p>","PeriodicalId":12161,"journal":{"name":"Eurosurveillance","volume":"30 21","pages":""},"PeriodicalIF":9.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12124111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144181686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Newly emerging metronidazole-resistant <i>Clostridioides difficile</i> PCR ribotype 955 identified in Poland, 2021 to 2023 but not in Czechia, 2012 to 2023 and Slovakia, 2015 to 2023.","authors":"Jaroslava Zikova, Klaudia Szarek, Monika Kabała, Dorota Wultańska, Natalia Frankowska, Adam Iwanicki, Krzysztof Hinc, Anna Mucha, Jolanta Komarnicka, Anna Jagielska, Ed Kuijper, Marcela Krutova, Hanna Pituch","doi":"10.2807/1560-7917.ES.2025.30.21.2400675","DOIUrl":"10.2807/1560-7917.ES.2025.30.21.2400675","url":null,"abstract":"<p><p>BackgroundOn 29 January 2024, the European Centre for Disease Prevention and Control distributed an alert about a metronidazole-resistant <i>Clostridioides difficile</i> outbreak of PCR ribotype (RT) 955 in England.AimWe aimed to investigate the presence of RT955 in Czech, Slovak and Polish <i>C. difficile</i> isolates and evaluate different culture media for detecting its metronidazole resistance.MethodsIsolates with binary toxin genes identified as 'unknown' by the WEBRIBO PCR ribotyping database up to 2023 were re-analysed after adding the RT955 profile to the database. The RT955 isolates were characterised by whole genome sequencing and tested for susceptibility to 15 antimicrobials.ResultsWe did not find RT955 in Czech (n = 6,661, 2012-2023) and Slovak (n = 776, 2015-2023) isolates, but identified 13 RT955 cases (n = 303, 2021-2023) in three hospitals in Poland. By whole genome multilocus sequence typing, 10 isolates clustered into one clonal complex including a sequence of United Kingdom strain ERR12670107, and shared similar antimicrobial resistance genes/mutations. All 13 isolates were resistant to ciprofloxacin/moxifloxacin, erythromycin/clindamycin and ceftazidime. All isolates had a mutation in the <i>nim</i>B gene promoter and in NimB (Tyr130Ser and Leu155Ile). The metronidazole resistance was detected in all isolates using brain-heart-infusion agar supplemented with haemin and Chocolate agar. Results were discrepant with the European Committee on Antimicrobial Susceptibility Testing-recommended Fastidious anaerobe agar and Brucella blood agar.ConclusionThe identification of clonally related haem-dependent metronidazole-resistant <i>C. difficile</i> RT955 in multiple hospitals indicates a need for prospective surveillance to estimate its prevalence in Europe.</p>","PeriodicalId":12161,"journal":{"name":"Eurosurveillance","volume":"30 21","pages":""},"PeriodicalIF":9.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12124108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144179604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of an updated methodology to estimate the burden of healthcare-associated infections in Italy, 2022.","authors":"Costanza Vicentini, Valerio Bordino, Luca Bresciano, Stefania Di Giacomo, Fortunato D'Ancona, Carla Maria Zotti","doi":"10.2807/1560-7917.ES.2025.30.18.2400812","DOIUrl":"https://doi.org/10.2807/1560-7917.ES.2025.30.18.2400812","url":null,"abstract":"<p><p>BackgroundAccurate burden estimates are necessary to inform priority setting and rational resource allocation. Weighting prevalence inversely proportional to time-at-risk has been proposed as a solution for length-biased sampling, an important limitation affecting prevalence to incidence conversion for healthcare-associated infections (HAIs).AimThis study aimed to update Italian burden estimates by calculating HAI incidence, attributable mortality and disability-adjusted life years (DALYs). Further, we describe an adapted methodology for burden estimations.MethodsWe used data from the latest European Centre for Disease Prevention and Control (ECDC) point prevalence survey (PPS) of HAIs, conducted in Italy in November 2022, to calculate the burden of five major HAIs at national level. We adapted the Burden of Communicable Diseases in Europe (BCoDE) methodology to include inverse probability weighting and compared results of naïve and weighted calculations.ResultsThe national sample included 18,397 patients. Overall, 564.8 DALYs per 100,000 general population resulted from weighted calculations (95% uncertainty interval (UI): 450.04-694.38), with an annual incidence of 685.42 cases per 100,000 general population (95% UI: 611.09-760.86) and 33.23 deaths per 100,000 general population per year (95% UI: 28.62-38.33). Concerning naïve estimates, overall 1,017.81 DALYs per 100,000 general population were calculated (95% UI: 855.16-1,190.59). In both calculations, healthcare-acquired bloodstream infections had the highest burden in terms of DALYs per 100,000 hospitalised and general population.ConclusionOur study confirmed the substantial burden of HAIs in Italy and renews the need to prioritise resources for infection prevention and control interventions.</p>","PeriodicalId":12161,"journal":{"name":"Eurosurveillance","volume":"30 18","pages":""},"PeriodicalIF":9.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12066978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence, case-fatality rates and risk factors of bloodstream infections caused by <i>Escherichia coli</i>, <i>Klebsiella</i> species and <i>Pseudomonas aeruginosa</i>, England, April 2017 to March 2022.","authors":"Olisaeloka Nsonwu, Simon Thelwall, Sarah Gerver, Rebecca L Guy, Dimple Chudasama, Russell Hope","doi":"10.2807/1560-7917.ES.2025.30.17.2400430","DOIUrl":"https://doi.org/10.2807/1560-7917.ES.2025.30.17.2400430","url":null,"abstract":"<p><p>Background<i>Escherichia coli</i>, <i>Klebsiella</i> spp. and <i>Pseudomonas aeruginosa</i> are included in the mandatory surveillance of bloodstream infections (BSI) in England.AimWe aimed to investigate the epidemiology of these BSIs in England April 2017-March 2022.MethodsWe extracted data on <i>E. coli</i>, <i>Klebsiella</i> spp. and <i>P. aeruginosa</i> BSI, categorised BSIs as healthcare-associated (HA) or community-associated (CA) and linked to antimicrobial susceptibility and mortality data. We used multivariable logistic regression models to assess predictors of mortality.ResultsThe incidence rate of <i>E. coli</i> BSI was 71.8 per 100,000 population (95% confidence interval (CI): 71.5-72.1), <i>Klebsiella</i> spp. 19.1 (95% CI: 18.9-19.3) and <i>P. aeruginosa</i> 7.6 (95% CI: 7.5-7.7). Most (65,467/104,957) BSI episodes were CA. Case-fatality rate was 14.8% (95% CI: 14.6-14.9) in <i>E. coli</i>, 20.0% (95% CI: 19.6-20.3) in <i>Klebsiella</i> spp. and 25.8% (95% CI: 25.2-26.4) in <i>P. aeruginosa</i> BSI. Urinary tract infection (UTI) was the most reported primary infection for <i>E. coli</i> (56,961/100,834), <i>Klebsiella</i> spp. (9,098/22,827) and <i>P. aeruginosa</i> (3,204/8,484) BSI. Insertion or manipulation of urinary catheters was reported for 26.4% (16,136/61,043) of <i>E. coli</i>, 41.6% (4,470 /10,734) of <i>Klebsiella</i> spp. and 49.0% (2,127/4,341) of <i>P. aeruginosa</i> BSI. The adjusted odds ratio (OR) of death among hospital-onset HA-BSI compared to CA-BSI was 2.0 (95% CI: 1.9-2.2) for <i>E. coli</i>, 2.1 (95% CI: 2.0-2.3) for <i>Klebsiella</i> spp. and 1.7 (95% CI: 1.5-2.0) for <i>P. aeruginosa</i>.ConclusionsAppropriate management of UTIs and urinary catheterisation is essential for reduction of these BSIs.</p>","PeriodicalId":12161,"journal":{"name":"Eurosurveillance","volume":"30 17","pages":""},"PeriodicalIF":9.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143973865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From multiple measles genotype D8 introductions in 2024 to sustained B3 local transmission in and around Milan, northern Italy, January to April 2025.","authors":"Clara Fappani, Maria Gori, Silvia Bianchi, Lucia Tieghi, Daniela Colzani, Sabrina Senatore, Marino Faccini, Priscilla Pasutto, Luca Imeri, Luigi Vezzosi, Gabriele Del Castillo, Simone Villa, Danilo Cereda, Silvia Gioacchini, Paola Bucci, Raoul Fioravanti, Emilio D'Ugo, Melissa Baggieri, Fabio Magurano, Antonella Amendola","doi":"10.2807/1560-7917.ES.2025.30.20.2500315","DOIUrl":"10.2807/1560-7917.ES.2025.30.20.2500315","url":null,"abstract":"<p><p>An outbreak of measles virus genotype B3 is ongoing in Milan and surrounding areas since February 2025, with 27 cases identified in 32 laboratory-confirmed measles cases. Most cases were locally acquired and young adults. Phylogenetic analysis indicated the presence of a unique lineage closely related to strains circulating in Morocco. The lack of epidemiological links between several affected individuals suggests case numbers are being underestimated. The continuous transmission raises concerns about the potential re-establishment of endemic circulation in northern Italy.</p>","PeriodicalId":12161,"journal":{"name":"Eurosurveillance","volume":"30 20","pages":""},"PeriodicalIF":9.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spread of the novel vancomycin-resistant <i>Enterococcus faecium</i> strain ST1299/vanA from local level in Germany to cross-border level in Austria, 2018 to 2022.","authors":"Anca Rath, Bärbel Kieninger, Nilufarbayim Mirzaliyeva, Guido Werner, Jennifer K Bender, Martin A Fischer, Adriana Cabal-Rosel, Werner Ruppitsch, Helena Mb Seth-Smith, Adrian Egli, Milo Halabi, Anna Hörtenhuber, Yarub Salaheddin, Wolfgang Prammer, Heidrun Kerschner, Rainer Hartl, Martin Ehrenschwender, Andreas Ambrosch, Jörn Kalinowski, Levin Joe Klages, Christian Rückert-Reed, Tobias Busche, Alexander Kratzer, Aila Caplunik-Pratsch, Anja Eichner, Jürgen Fritsch, Wulf Schneider-Brachert","doi":"10.2807/1560-7917.ES.2025.30.20.2400389","DOIUrl":"10.2807/1560-7917.ES.2025.30.20.2400389","url":null,"abstract":"<p><p>IntroductionVancomycin-resistant <i>Enterococcus faecium</i> (VREfm) isolates of sequence type (ST)1299 were described recently in south-eastern German hospitals and rapidly expanded from local to cross-border level.AimWe describe the spread of the novel VREfm strain ST1299/vanA on a genetic, geographical and temporal level during the first 5 years after its detection.MethodsAt University Hospital Regensburg (UHoR), routine VREfm surveillance is whole genome sequencing-based (≥ 1 VREfm per <i>van</i>-genotype, patient and year). In this observational cohort study, we analysed one VREfm ST1299 isolate from our database (2016-2022) per patient and year. Isolates were added from the Hospital of the Merciful Brothers Regensburg (MBR), the National Reference Centre for Staphylococci and Enterococci (NRC), and clinical isolates from Austria.ResultsWe identified 635 VREfm ST1299 isolates (100% <i>vanA</i>), including 504 from Regensburg, and 113 blood cultures. ST1299 isolates were first detected in 2018 simultaneously in Regensburg (n = 2) and southern Bavaria (n = 2), with local (UHoR) and regional numbers increasing rapidly from 2020, shifting to national scale in the same year. Genome data, analysed by cgMLST, showed a predominance of ST1299/CT1903 (315/504 isolates, 62.5%) and ST1299/CT3109 (127/504 isolates, 25.2%) isolates from Regensburg. By 2021, ST1299/CT1903 reached Upper Austria causing hospital outbreaks (n = 5). Phylogeny analysis suggests common ancestors with VREfm ST80, ST18 and ST17.ConclusionSince their emergence in 2018, two highly transmissible subtypes of ST1299/<i>vanA</i> reached national, then cross-border scale. The observed outbreak tendency may explain the rapid and successful spread and the high clonality in our collection.</p>","PeriodicalId":12161,"journal":{"name":"Eurosurveillance","volume":"30 20","pages":""},"PeriodicalIF":9.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frameworks to support evidence-informed decision-making in public health and infectious disease prevention and control: a scoping review.","authors":"Yang Song, Javier Bracchiglione, Jose F Meneses-Echávez, Helena de Carvalho Gomes, Barbara Albiger, Ivan Solà, David Rigau, Pablo Alonso-Coello","doi":"10.2807/1560-7917.ES.2025.30.19.2400185","DOIUrl":"10.2807/1560-7917.ES.2025.30.19.2400185","url":null,"abstract":"<p><p>BackgroundEvidence-informed public health decision-making (EIDM) is a complex process that must consider multiple factors.AimWe aimed to identify and describe existing frameworks supporting evidence-informed public health decision-making and their application to infectious disease.MethodsWe conducted a scoping review to describe current EIDM framework use in public health. We included decision-making frameworks in public health and examples of their use in infectious diseases. We searched MEDLINE and Health Systems Evidence from inception to December 2022. We also hand searched websites of relevant organisations and conducted a forward citation search of the included frameworks. Two reviewers selected studies independently, one reviewer extracted data and one cross-checked for accuracy. We presented the results narratively.ResultsWe included 15 frameworks. Seven had a generic scope and eight were focused on specific topics (immunisation, COVID-19 or other, non-infectious diseases). From the included frameworks, we identified a total of 18 criteria with each framework assessing a median of eight, the most frequent being 'desirable effects', 'resources considerations' and 'feasibility'. We identified infectious disease examples for four frameworks: 'Grading of Recommendations, Assessment, Development, and Evaluation' (GRADE), WHO-INTEGRATe Evidence (WHO-INTEGRATE), 'Ethics, Equity, Feasibility, and Acceptability' (EEFA) and 'Community Preventive Services Task Force' (CPSTF) evidence-to-decision frameworks.ConclusionAlthough several EIDM frameworks exist for public health decision-making, most have not been widely applied to infectious diseases. Current EIDM frameworks inconsistently address factors for public health decision-making. Further application and evaluation, and possibly adaptation of existing frameworks, is required to optimise decision-making in public health and infectious diseases.</p>","PeriodicalId":12161,"journal":{"name":"Eurosurveillance","volume":"30 19","pages":""},"PeriodicalIF":9.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12083068/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Doubling of triazole resistance rates in invasive aspergillosis over a 10-year period, Belgium, 1 April 2022 to 31 March 2023.","authors":"Lize Cuypers, Robina Aerts, Otto Van de Gaer, Lore Vinken, Rita Merckx, Veerle Gerils, Greetje Vande Velde, Agustin Reséndiz-Sharpe, Johan Maertens, Katrien Lagrou","doi":"10.2807/1560-7917.ES.2025.30.18.2400559","DOIUrl":"https://doi.org/10.2807/1560-7917.ES.2025.30.18.2400559","url":null,"abstract":"<p><p>BackgroundDutch national treatment guidelines for fungal infections have been adapted based on surveillance findings of triazole resistance rates >10% in <i>Aspergillus</i> species isolates. In Belgium, nationwide resistance data have not been collected since 2011.AimOur objective was to evaluate changes in antifungal susceptibility among <i>Aspergillus</i> species isolates from patients with invasive aspergillosis.MethodsLaboratories across Belgium were invited to send all clinically relevant <i>Aspergillus</i> species isolates from patients diagnosed with invasive aspergillosis, collected between April 2022 and March 2023, to the National Reference Centre for Mycosis at UZ Leuven for identification and antifungal susceptibility testing.ResultsOverall, 29 clinical laboratories contributed 309 isolates from 297 patients. Median patient age was 66 years (range: 6 months-96 years). Among isolates, 61% (189/309) were from male patients. At species level, <i>Aspergillus fumigatus</i> isolates predominated (278/309, 90%), with a 9.7% (27/278) triazole resistance rate, compared to the 4.6% rate found in 2011. Of 27 resistant isolates, successful <i>Cyp51A</i> sequencing of 26 showed 20 with the TR₃₄/L98H resistance mechanism. Across the country, local <i>A. fumigatus</i> triazole resistance rates varied. Among provinces in the Flanders region, Antwerp had the highest resistance rate (15.4%: 10/65; p = 0.082), Flemish Brabant (6/48) also had a rate >10%, while Limburg (2/46) had the lowest rate.ConclusionsGeographical differences in <i>A. fumigatus</i> triazole resistance rates stress the importance of implementing broad prospective surveillance initiatives, not limited to one region or one hospital. In Belgium, triazole resistance rates have doubled over 10 years, nearly attaining the 10% threshold, warranting re-evaluation of local empirical antifungal treatment regimen decisions.</p>","PeriodicalId":12161,"journal":{"name":"Eurosurveillance","volume":"30 18","pages":""},"PeriodicalIF":9.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12066980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143975502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}