Cronobacter sakazakii has been documented as a cause of life-threating infections, predominantly in neonates. We conducted a multicenter study to assess the occurrence of C. sakazakii across Europe... Show moreCronobacter sakazakii has been documented as a cause of life-threating infections, predominantly in neonates. We conducted a multicenter study to assess the occurrence of C. sakazakii across Europe and the extent of clonality for outbreak detection. National coordinators representing 24 countries in Europe were requested to submit all human C. sakazakii isolates collected during 2017 to a study center in Austria. Testing at the center included species identification by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry, subtyping by whole-genome sequencing (WGS), and determination of antimicrobial resistance. Eleven countries sent 77 isolates, including 36 isolates from 2017 and 41 historical isolates. Fifty-nine isolates were confirmed as C. sakazakii by WGS, highlighting the challenge of correctly identifying Cronobacter spp. WGS-based typing revealed high strain diversity, indicating absence of multi-national outbreaks in 2017, but identified 4 previously unpublished historical outbreaks. WGS is the recommended method for accurate identification, typing, and detection of this pathogen. Show less
Dobreva, E.; Ivanov, I.; Dobrevska, R.V.; Ivanova, K.; Marina, M.; Petrov, P.; ... ; Kuijper, E. 2012
Clostridium difficile is one of the most important causative agents of severe diarrhoea in hospitalised patients treated with antibiotics. Since 2008, Bulgaria participated in the Pan-European... Show moreClostridium difficile is one of the most important causative agents of severe diarrhoea in hospitalised patients treated with antibiotics. Since 2008, Bulgaria participated in the Pan-European Surveillance Study investigating the prevalence of C. difficile infections (CDI) in different European countries. In the period November 2008 - March 2010, the incidence of CDI in nine participating hospitals was 7.94 per 10 000 patient admissions (0.34 per 10 000 patient-days). In total, sixty five fecal samples from patients with mild to severe enterocolitis and previous antibiotic treatment were investigated for CDI. Strains were typed and further characterized for the presence of toxins A (TcdA), B (TcdB) and binary toxins (CdtA and CdtB). Of 65 stool samples included, 15 were toxin and culture positive for C. difficile. Six of the isolates (40%) belonged to PCR ribotype 017 (TcdA(-).; TcdB(+); CdtA/B-), followed by 002 (n = 2 isolates) and 014 (n = 2 isolates). The remaining C. difficile isolates were typed as 012 (n = 1), 046 (n = 1), 078 ribotypes (n = 1) and 2 isolates were untypable. In conclusion, after the Pan-European surveillance study, a laboratory-based surveillance of CDI has been introduced in Bulgaria. The most prevalent C. difficile ribotype in Bulgaria was 017 (40%). All determined PCR ribotypes were found to be associated with severe CDI and a high percentage of lethal outcomes, indicating that improvements of surveillance with appropriate clinical and epidemiological criteria is warranted. Show less
