How to predict ESBL (part 3)

Six weeks ago I introduced the ESBL-predict study that Tim Deelen from our group coordinates. Every hospital in the world can participate through a user-friendly electronic CRF (in a secured environment). My blog-invitation to particpate worked and some sites already started. In June >1,000 episodes were entered! Here is a short update and info for those that want to join.  Continue reading

Exposed: Dutch clinical microbiologists

Exposed; that’s what we are. We, Dutch clinical microbiologists. Globally acknowledged for our capacity to control antibiotic resistance, prevent hospital-acquired infections (HAI) and practice the most rational and restrictive antibiotic policies. That we are self-confident, loud and arrogant  is taken for granted, as most do with Christiano Ronaldo. But it is with great sadness that I have to announce that it was all FAKE. The balloon was pricked by professor Marcel Levi. Continue reading

Real-time whole genome sequencing (RT-WGS) & spread of resistant bacteria

At last weeks’ ICPIC I crossed arguments with John Rossen on the question whether RT-WGS helps us to control the spread of resistant bacteria. The setting is the hospital and the definition of RT is “in time to guide essential decision making”. Is RT-WGS a “need-to-have” or a “nice-to-have” thing? Continue reading

The rocket-science of a CPE screen & isolate policy

Last weeks’ blog from Jon Otter on the practice of CPE screening and isolation raised some interesting comments (on twitter) emphasizing the difficulties in policy making for infection control. The two comments that struck me were: (1) … screening for CPE sounds logical “but does it work in long-term care facilities with high-levels of endemicity?” And “I use it in my hospital, but face difficulties in convincing others because of lacking scientific evidence for CPE.” Continue reading

LA-MRSA: On the definition of emergence

Some friends, called patriotic hackers, had secured a very interesting surveillance database and I tried to write a manuscript, when I was scooped (in CID) by friends that apparently had access to the same database. That made my work redundant. So, for your eyes only, my take on that data. Continue reading

Looking back to see the post-antibiotic era

Now online in Lancet ID an impressive and important retrospective study describing the faith of 437 patients with BSI caused by carbapenamase-producing Enterobacteriaceae (CPE). When scanning the conclusions of your weekly diarrhea of new papers (as I do) this one might have escaped your attention: (in short) “Appropriate therapy is good. Combination therapy too. Patients with BSIs due to CPE should receive active therapy.” Yet, there is much more interesting stuff in this paper. Continue reading

How to predict ESBL BSI (part 2)

A month ago (April 11) I blogged on the difficulties in predicting the presence of ESBL-producing bacteria as a cause of infection at the time antibiotics must be started. Wouter Rottier (PhD student) developed 2 prediction rules (for community-onset and hospital-onset infection), that seem to do better than current guideline recommendations (especially for reducing unnecessary carbapenem use). Another PhD student (Tim Deelen) now wants to validate these rules, globally. The “crowd-funding study approach” worked and sites across the world joined us…. Continue reading