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Article ; Online: Impact of the COVID-19 pandemic on

Tossens, Bastien / Barthelme, Philippe / Briquet, Caroline / Belkhir, Leila / Ngyuvula, Eléonore / Soumillion, Kate / Verroken, Alexia / Rodriguez-Villalobos, Hector / Delmée, Michel / Anantharajah, Ahalieyah

Acta clinica Belgica

2023 Volume 78, Issue 6, Page(s) 459–466

Abstract: Objectives: Clostridioides difficile infection (CDI) causes the greatest number of healthcare-associated infectious diarrhoea. CDIs are transmitted by direct and indirect patient-to-patient contact and risk increases with the use of antibiotics. Since ... ...

Abstract	Objectives: Clostridioides difficile infection (CDI) causes the greatest number of healthcare-associated infectious diarrhoea. CDIs are transmitted by direct and indirect patient-to-patient contact and risk increases with the use of antibiotics. Since early 2020, the COVID-19 pandemic has affected healthcare systems in many ways including substantial changes in hygiene behaviour. The aim of this study was to assess whether CDI incidence differed during the COVID-19 pandemic compared to a year before. Methods: All tests for suspected CDI cases were recorded for a hospital in Brussels, Belgium. The percentage of CDI-positive results and incidences (total and healthcare-associated (HA)-CDI)) for years 2019, 2020, 2021, and 2022 were calculated. Antibiotic consumption was analysed for years 2019 and 2020. Results: Since the COVID-19 pandemic struck, a significant reduction of up to 39% was observed in the number of Conclusion: The global decrease in CDI incidence observed in our hospital was not associated with a change in the use of antibiotics. The control measures implemented to prevent COVID-19 transmission may explain a reduction in CDI incidence. An underdiagnosis of CDI cannot be excluded.
Language	English
Publishing date	2023-08-23
Publishing country	England
Document type	Journal Article
ZDB-ID	390201-8
ISSN	2295-3337 ; 0001-5512 ; 1784-3286
ISSN (online)	2295-3337
ISSN	0001-5512 ; 1784-3286
DOI	10.1080/17843286.2023.2250624
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Article: Laboratory diagnosis of Clostridium difficile disease.

Delmée, M

Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases

2001 Volume 7, Issue 8, Page(s) 411–416

Abstract: The laboratory diagnosis of Clostridium difficile-associated disease (CDAD) is based on culture and toxin detection in fecal specimens. Culture is performed on a commercially available selective media. C. difficile colony morphology is typical when ... ...

Abstract	The laboratory diagnosis of Clostridium difficile-associated disease (CDAD) is based on culture and toxin detection in fecal specimens. Culture is performed on a commercially available selective media. C. difficile colony morphology is typical when viewed under a dissecting microscope. Definitive identification is best obtained by gas liquid chromatography. Culture is very sensitive but, when used alone without toxin testing, it leads to low specificity and misdiagnosis of CDAD when high rates of asymptomatic carriage exist. Toxin detection by a tissue culture cytotoxin assay followed by neutralisation with specific antiserum is often considered the standard. However, this approach lacks sensitivity and has not detected up to 30% of patients with confirmed CDAD. Multiple enzyme immunoassays (EIAs) have been introduced by various manufacturers for the detection of toxin A alone or for both toxins A and B. Some of these are designed to give results in less than 1 h. Comparative studies of EIA kits reported that the sensitivity and specificity are slightly lower than cytotoxin assays. Toxigenic culture tests C. difficile isolates for toxin production: colonies isolated on selective media are tested for in-vitro toxin production either by a cytotoxicity assay or by direct EIA. It has higher sensitivity than the cytotoxicity assay and equivalent specificity. In the routine laboratory, culture and toxin detection should be performed on every specimen and, in culture-positive and fecal toxin-negative cases, toxigenic cultures should be performed on isolated colonies.
MeSH term(s)	Antibodies, Bacterial/analysis ; Bacterial Proteins ; Bacterial Toxins/analysis ; Clostridium difficile/growth & development ; Clostridium difficile/isolation & purification ; Enterocolitis, Pseudomembranous/diagnosis ; Enterocolitis, Pseudomembranous/microbiology ; Enterotoxins/analysis ; Feces/chemistry ; Feces/microbiology ; Humans ; Immunoenzyme Techniques ; Reagent Kits, Diagnostic ; Sensitivity and Specificity
Chemical Substances	Antibodies, Bacterial ; Bacterial Proteins ; Bacterial Toxins ; Enterotoxins ; Reagent Kits, Diagnostic ; tcdA protein, Clostridium difficile ; toxB protein, Clostridium difficile
Language	English
Publishing date	2001-08
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	1328418-6
ISSN	1469-0691 ; 1198-743X ; 1470-9465
ISSN (online)	1469-0691
ISSN	1198-743X ; 1470-9465
DOI	10.1046/j.1198-743x.2001.00294.x
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Article ; Online: Clinical and laboratory features of the most common Clostridium difficile ribotypes isolated in Belgium.

Neely, F / Lambert, M-L / Van Broeck, J / Delmée, M

The Journal of hospital infection

2016 Volume 95, Issue 4, Page(s) 394–399

Abstract: Background: Previous studies comparing Clostridium difficile infection (CDI) due to different ribotypes have been conflicting, and many have only compared small numbers of cases or few ribotypes.: Aim: To compare patient and episode characteristics ... ...

Abstract	Background: Previous studies comparing Clostridium difficile infection (CDI) due to different ribotypes have been conflicting, and many have only compared small numbers of cases or few ribotypes. Aim: To compare patient and episode characteristics for CDI due to different ribotypes. Methods: The ribotyping results from 3333 toxin-producing isolates collected from 110 Belgian hospitals between October 2010 and December 2015 were matched to clinical data from the national CDI surveillance database. Data for ribotypes with at least 100 occurrences were compared. In addition, the national reference laboratory quantitatively measured the level of toxin production in five randomly chosen cultured isolates for each of the most common ribotypes. Findings: Ribotypes with more than 100 occurrences were R014, R020, R002, R078, R027, R005 and R106 (Brazier classification). The median age for all patients was 79 years [patients with R027, 83 years (P<0.001); patients with R106, 73 years (P<0.001)]. In total, 10% of episodes were recurrences; values were higher for R027 (22%) and R106 (18%). CDI due to R078 was not significantly more likely to be community associated than healthcare associated (28% vs 24%; P=0.1). Complications occurred in 7% of all episodes, and 12% for those with R027 and R078. However, after adjusting for age, onset outside the hospital and recurrence, R027 was no longer associated with complications [odds ratio (OR) 1.3, 95% confidence interval (CI) 0.7-2.4], unlike R078 (OR 1.7, 95% CI 1.0-2.6; P=0.04). A positive stool toxin test and greater levels of toxin production in the cultured isolates were more likely for R078 and R027. Conclusion: Out of the seven most common ribotypes in hospital patients, R078 and R027 were associated with higher rates of complications. Infections with R027 and R106 were more likely to be recurrent. The presence of toxin in stools was most likely with R078, R027 and R106, with highest levels of toxin production in vitro for R078 and R027. R060 produced the lowest levels of toxin in vitro.
MeSH term(s)	Aged ; Aged, 80 and over ; Bacterial Toxins/analysis ; Belgium/epidemiology ; Clostridium Infections/epidemiology ; Clostridium Infections/microbiology ; Clostridium Infections/pathology ; Clostridium difficile/classification ; Clostridium difficile/genetics ; Clostridium difficile/isolation & purification ; Colitis/epidemiology ; Colitis/microbiology ; Colitis/pathology ; Cross Infection/epidemiology ; Cross Infection/microbiology ; Cross Infection/pathology ; Feces/chemistry ; Female ; Hospitals ; Humans ; Male ; Ribotyping
Chemical Substances	Bacterial Toxins
Language	English
Publishing date	2016-12-18
Publishing country	England
Document type	Journal Article
ZDB-ID	779366-2
ISSN	1532-2939 ; 0195-6701
ISSN (online)	1532-2939
ISSN	0195-6701
DOI	10.1016/j.jhin.2016.12.011
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Article: Corrigendum to "

Rodriguez, C / Taminiau, B / Bouchafa, L / Romijn, S / Rajamäki, M M / Van Broeck, J / Delmée, M / Clercx, C / Daube, G

Heliyon

2019 Volume 5, Issue 6, Page(s) e01890

Abstract: This corrects the article DOI: 10.1016/j.heliyon.2019.e01629.]. ...

Abstract	[This corrects the article DOI: 10.1016/j.heliyon.2019.e01629.].
Language	English
Publishing date	2019-06-14
Publishing country	England
Document type	Published Erratum
ZDB-ID	2835763-2
ISSN	2405-8440
ISSN	2405-8440
DOI	10.1016/j.heliyon.2019.e01890
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Article: Problem microorganisms.

Delmée, M

Acta clinica Belgica

1998 Volume 53, Issue 3, Page(s) 162–167

MeSH term(s)	Belgium/epidemiology ; Candidiasis/epidemiology ; Candidiasis/microbiology ; Candidiasis/prevention & control ; Cross Infection/epidemiology ; Cross Infection/microbiology ; Cross Infection/prevention & control ; Drug Resistance, Microbial ; Gram-Negative Bacterial Infections/epidemiology ; Gram-Negative Bacterial Infections/microbiology ; Gram-Negative Bacterial Infections/prevention & control ; Gram-Positive Bacterial Infections/epidemiology ; Gram-Positive Bacterial Infections/microbiology ; Gram-Positive Bacterial Infections/prevention & control ; Humans ; Infection Control ; Microbial Sensitivity Tests
Language	English
Publishing date	1998-06
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	390201-8
ISSN	2295-3337 ; 1784-3286 ; 0001-5512
ISSN (online)	2295-3337
ISSN	1784-3286 ; 0001-5512
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Article: Clostridium difficile

Rodriguez, C / Taminiau, B / Bouchafa, L / Romijn, S / Van Broeck, J / Delmée, M / Clercx, C / Daube, G

Heliyon

2019 Volume 5, Issue 5, Page(s) e01629

Abstract: Zoonotic transmission ... ...

Abstract	Zoonotic transmission of
Language	English
Publishing date	2019-05-13
Publishing country	England
Document type	Journal Article
ZDB-ID	2835763-2
ISSN	2405-8440
ISSN	2405-8440
DOI	10.1016/j.heliyon.2019.e01629
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Article: Dutch borders impervious to ticks or Lyme borreliosis underreporting in Belgium.

Obsomer, V / Boucher, I / Delmée, M

Acta clinica Belgica

2013 Volume 68, Issue 5, Page(s) 390

MeSH term(s)	Animals ; Belgium/epidemiology ; Blotting, Western ; Humans ; Incidence ; Lyme Disease/epidemiology ; Tick-Borne Diseases/epidemiology ; Ticks
Language	English
Publishing date	2013-09
Publishing country	England
Document type	Letter
ZDB-ID	390201-8
ISSN	2295-3337 ; 1784-3286 ; 0001-5512
ISSN (online)	2295-3337
ISSN	1784-3286 ; 0001-5512
DOI	10.2143/ACB.3427
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Article ; Online: Seasonality of Clostridium difficile in the natural environment.

Rodriguez, Cristina / Bouchafa, Lamia / Soumillion, Kate / Ngyuvula, Eleonore / Taminiau, Bernard / Van Broeck, Johan / Delmée, Michel / Daube, Georges

Transboundary and emerging diseases

2019 Volume 66, Issue 6, Page(s) 2440–2449

Abstract: Clostridium difficile is considered the leading cause of antibiotic-associated disease worldwide. In the past decade, a large number of studies have focused on identifying the main sources of contamination in order to elucidate the complete life cycle of ...

Abstract	Clostridium difficile is considered the leading cause of antibiotic-associated disease worldwide. In the past decade, a large number of studies have focused on identifying the main sources of contamination in order to elucidate the complete life cycle of the infection. Hospitals, animals and retail foods have been considered as potential vectors. However, the prevalence of C. difficile in these types of samples was found to be rather low, suggesting that other contamination routes must exist. This study explores the presence of C. difficile in the natural environment and the seasonal dynamics of the bacterium. C. difficile was isolated from a total of 45 samples out of 112 collected (40.2%) on 56 sampling points. A total of 17 points were positive only during the winter sampling (30.4%), 10 were positive only during the summer sampling (17.9%) and 9 sampling points (16.1%) were positive in both summer sampling and winter sampling. Spore counts in soil samples ranged between 50 and 250 cfu/g for 24.4% of the positive samples, with the highest concentrations detected in samples collected in the forest during winter campaign (200-250 cfu/g). A total of 17 different PCR ribotypes were identified, and 15 of them had the genes coding for toxins A and B. Most of those ribotypes had not previously been found or had been isolated only sporadically (<1% of samples) from hospitals in Belgium. Regarding antimicrobial susceptibility, most of the resistant strains were found during the summer campaign. These findings bear out that C. difficile is present in the natural environment, where the bacterium undergoes seasonal variations.
MeSH term(s)	Animals ; Belgium ; Clostridium difficile/drug effects ; Clostridium difficile/isolation & purification ; Colony Count, Microbial ; Drug Resistance, Microbial ; Humans ; Polymerase Chain Reaction ; Ribotyping ; Seasons ; Soil Microbiology ; Spores, Bacterial
Language	English
Publishing date	2019-08-07
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2414822-2
ISSN	1865-1682 ; 1865-1674
ISSN (online)	1865-1682
ISSN	1865-1674
DOI	10.1111/tbed.13301
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Article: Surveillance of Clostridium difficile infections in a long-term care psychogeriatric facility: outbreak analysis and policy improvement.

Van Esch, Gretel / Van Broeck, Johan / Delmée, Michel / Catry, Boudewijn

Archives of public health = Archives belges de sante publique

2015 Volume 73, Issue 1, Page(s) 18

Abstract: Background: Following an exceptionally high Clostridium difficile infections (CDI) incidence (Spring 2011) in a psychogeriatric long-term care facility, a bidirectional study (2009-2012) was initiated to identify determinants (retrospectively) and to ... ...

Abstract	Background: Following an exceptionally high Clostridium difficile infections (CDI) incidence (Spring 2011) in a psychogeriatric long-term care facility, a bidirectional study (2009-2012) was initiated to identify determinants (retrospectively) and to assess intervention measures taken (prospectively). Methods: For every CDI patient (de novo cases, relapses, and recurrences), a control patient (patient in the opposite room) was selected and risk factor analysis performed. Following the epidemic peak a more stringent hygienic protocol and surveillance program were implemented, as well as uniform guidelines for metronidazole and vancomycin prescription. Results: The nutritional state (total protein/prealbumine) significantly differed between the CDI group (poorer nutritional state at admission) and the control group, and also antibiotic use (general) could be confirmed as a risk factor. A multi-disciplinary nutritional team has been established in order to improve the nutritional balance of our patients. Conclusions: Aside from stringent hygiene and antibiotic prescription stewardship, malnutrition of patients is a factor to be taken into account to contain a CDI outbreak in a long term care facility (LTCF).
Language	English
Publishing date	2015-04-06
Publishing country	England
Document type	Journal Article
ZDB-ID	1117688-x
ISSN	2049-3258 ; 0778-7367 ; 0003-9578
ISSN (online)	2049-3258
ISSN	0778-7367 ; 0003-9578
DOI	10.1186/s13690-015-0067-y
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Article ; Online: Laser Ablation of Silver in Liquid Organic Monomer: Influence of Experimental Parameters on the Synthesized Silver Nanoparticles/Graphite Colloids.

Delmée, Maxime / Mertz, Grégory / Bardon, Julien / Marguier, Adeline / Ploux, Lydie / Roucoules, Vincent / Ruch, David

The journal of physical chemistry. B

2017 Volume 121, Issue 27, Page(s) 6646–6654

Abstract: During the past decade, synthesizing silver nanoparticles (Ag NPs) by liquid phase-pulsed laser ablation (LP-PLA) has attracted a lot of attention. Basically, this technique allows producing various metallic nanoparticles with controlled size, shape, ... ...

Abstract	During the past decade, synthesizing silver nanoparticles (Ag NPs) by liquid phase-pulsed laser ablation (LP-PLA) has attracted a lot of attention. Basically, this technique allows producing various metallic nanoparticles with controlled size, shape, composition, or surroundings in several liquids (i.e., water, ethanol, acetone, toluene, and so forth). Recently, such processes have been studied in liquid organic monomer such as methyl methacrylate (MMA). However, the influence of the laser parameters on the materials synthesized in such reactive liquid and their features were not fully investigated so far. Here we investigate the LP-PLA of silver in two different but rather similar acrylate monomers: dodecyl acrylate (DOCA) and 1H,1H,2H,2H perfluorodecyl acrylate (PFDA). The influence of the fluence and the number of pulses on the production, size, and morphology of the materials has been examined. First, factorial design experiments have been achieved in order to determine the weight of the laser parameters in each precursor. This study shows two highly different behaviors in function of the monomer where the process took place. This has been explained by the plasma plume confinement and/or the "interpulses" self-absorption of the particles by the laser beam. The formation of graphite around the synthesized AgNPs has been highlighted by Raman spectroscopy at low number of pulses. Nevertheless, increasing the number of pulses could lead to three phenomenon depending on the fluence and the used monomer: degradation of the matrix, conservation of the matrix with changes in AgNPs size and distribution, or sustainment of the matrix with any changes in the particles properties. So the surrounding, the size, and stability could be triggered by adjusting these parameters. This paper does highlight that LP-PLA is a powerful technique to provide AgNPs in acrylate monomer with a good control of their features.
Language	English
Publishing date	2017-07-13
Publishing country	United States
Document type	Journal Article
ISSN	1520-5207
ISSN (online)	1520-5207
DOI	10.1021/acs.jpcb.7b05409
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