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Article ; Online: Mortality and length of hospital stay after bloodstream infections caused by ESBL-producing compared to non-ESBL-producing

Handal, Nina / Whitworth, Jimmy / Lyngbakken, Magnus Nakrem / Berdal, Jan Erik / Dalgard, Olav / Bakken Jørgensen, Silje

Infectious diseases (London, England)

2023 Volume 56, Issue 1, Page(s) 19–31

Abstract: Objective: To compare mortality and length of hospital stay between patients with ESBL-producing : Methods: A retrospective case-control study among adults admitted between 2014 and 2021 to a Norwegian University Hospital.: Results: A total of 468 ...

Abstract	Objective: To compare mortality and length of hospital stay between patients with ESBL-producing Methods: A retrospective case-control study among adults admitted between 2014 and 2021 to a Norwegian University Hospital. Results: A total of 468 Conclusion: There was no statistically significant difference in 30-day mortality in ESBL-producing
MeSH term(s)	Adult ; Humans ; Escherichia coli ; Length of Stay ; Escherichia coli Infections/drug therapy ; Retrospective Studies ; Case-Control Studies ; Bacteremia/drug therapy ; beta-Lactamases ; Risk Factors ; Anti-Bacterial Agents/pharmacology ; Anti-Bacterial Agents/therapeutic use ; Sepsis/drug therapy
Chemical Substances	beta-Lactamases (EC 3.5.2.6) ; Anti-Bacterial Agents
Language	English
Publishing date	2023-12-18
Publishing country	England
Document type	Journal Article
ZDB-ID	2839775-7
ISSN	2374-4243 ; 2374-4235
ISSN (online)	2374-4243
ISSN	2374-4235
DOI	10.1080/23744235.2023.2261538
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Article ; Online: Comparison of SARS-CoV-2 infections in healthcare workers with high and low exposures to Covid-19 patients in a Norwegian University Hospital.

Handal, Nina / Whitworth, Jimmy / Blomfeldt, Anita / Espvik, Heidi Johanne / Lysaker, Elisabeth / Berdal, Jan Erik / Bakken Jørgensen, Silje

Infectious diseases (London, England)

2021 Volume 53, Issue 6, Page(s) 420–429

Abstract: Introduction: A year into the pandemic, the knowledge of SARS-CoV-2 infection risks among healthcare workers remains limited. In this cross-sectional study, we examined whether healthcare workers with high exposure to Covid-19 patients had a higher risk ...

Abstract	Introduction: A year into the pandemic, the knowledge of SARS-CoV-2 infection risks among healthcare workers remains limited. In this cross-sectional study, we examined whether healthcare workers with high exposure to Covid-19 patients had a higher risk of SARS-CoV-2 infection than other healthcare workers in a Norwegian University Hospital. We also investigated the prevalence of asymptomatic healthcare workers in a ward with a SARS-CoV-2 outbreak. Methods: Healthcare workers from five wards at Akershus University Hospital were included between May 11 and June 11, 2020. Blood samples were analyzed for SARS-CoV-2 antibodies and seroprevalences compared between participants with high and low exposure to Covid-19 patients. Demographic data and SARS-CoV-2 infection risk factors were recorded in a questionnaire. Naso-/oropharyngeal swabs from participants from the outbreak ward were analyzed by reverse transcriptase-polymerase chain reaction. Results: 360/436 (82.6%) healthcare workers participated. 9/262 (3.4%) participants from wards with high exposure to Covid-19 patients were SARS-CoV-2 seropositive versus 3/98 (3.1%) from wards with low exposure (OR 1.13; 95%CI 0.3-4.26, Conclusion: We found no significantly increased risk of SARS-CoV-2 infection in healthcare workers with high exposure to COVID-19 patients. Five healthcare workers had either serologic or molecular evidence of past or present unrecognized SARS-CoV-2 infection.
MeSH term(s)	COVID-19 ; Cross-Sectional Studies ; Health Personnel ; Humans ; Pandemics ; SARS-CoV-2
Language	English
Publishing date	2021-02-23
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2839775-7
ISSN	2374-4243 ; 2374-4235
ISSN (online)	2374-4243
ISSN	2374-4235
DOI	10.1080/23744235.2021.1885734
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Article ; Online: Risk of death in Klebsiella pneumoniae bloodstream infections is associated with specific phylogenetic lineages.

The Journal of infection

2024 Volume 88, Issue 5, Page(s) 106155

Abstract: Background: Klebsiella pneumoniae species complex (KpSC) bloodstream infections (BSIs) are associated with considerable morbidity and mortality, particularly in elderly and multimorbid patients. Multidrug-resistant (MDR) strains have been associated ... ...

Abstract	Background: Klebsiella pneumoniae species complex (KpSC) bloodstream infections (BSIs) are associated with considerable morbidity and mortality, particularly in elderly and multimorbid patients. Multidrug-resistant (MDR) strains have been associated with poorer outcome. However, the clinical impact of KpSC phylogenetic lineages on BSI outcome is unclear. Methods: In an 18-month nationwide Norwegian prospective study of KpSC BSI episodes in adults, we used whole-genome sequencing to describe the molecular epidemiology of KpSC, and multivariable Cox regression analysis including clinical data to determine adjusted hazard ratios (aHR) for death associated with specific genomic lineages. Findings: We included 1078 BSI episodes and 1082 bacterial isolates from 1055 patients. The overall 30-day case-fatality rate (CFR) was 12.5%. Median patient age was 73.4, 61.7% of patients were male. Median Charlson comorbidity score was 3. Klebsiella pneumoniae sensu stricto (Kp) (79.3%, n = 858/1082) and K. variicola (15.7%, n = 170/1082) were the dominating phylogroups. Global MDR-associated Kp clonal groups (CGs) were prevalent (25.0%, n = 270/1082) but 78.9% (n = 213/270) were not MDR, and 53.7% (n = 145/270) were community acquired. The major findings were increased risk for death within 30 days in monomicrobial BSIs caused by K. variicola (CFR 16.9%, n = 21; aHR 1.86, CI 1.10-3.17, p = 0.02), and global MDR-associated Kp CGs (CFR 17.0%, n = 36; aHR 1.52, CI 0.98-2.38, p = 0.06) compared to Kp CGs not associated with MDR (CFR 10.1%, n = 46). Conclusion: Bacterial traits, beyond antimicrobial resistance, have a major impact on the clinical outcome of KpSC BSIs. The global spread of MDR-associated Kp CGs is driven by other mechanisms than antibiotic selection alone. Further insights into virulence determinants, and their association with phylogenetic lineages are needed to better understand the epidemiology of KpSC infection and clinical outcome.
MeSH term(s)	Humans ; Klebsiella pneumoniae/genetics ; Klebsiella pneumoniae/classification ; Klebsiella pneumoniae/isolation & purification ; Male ; Klebsiella Infections/mortality ; Klebsiella Infections/microbiology ; Klebsiella Infections/epidemiology ; Female ; Aged ; Phylogeny ; Prospective Studies ; Bacteremia/microbiology ; Bacteremia/mortality ; Bacteremia/epidemiology ; Middle Aged ; Drug Resistance, Multiple, Bacterial ; Aged, 80 and over ; Norway/epidemiology ; Whole Genome Sequencing ; Risk Factors ; Molecular Epidemiology ; Anti-Bacterial Agents/therapeutic use ; Anti-Bacterial Agents/pharmacology ; Adult
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2024-04-02
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	424417-5
ISSN	1532-2742 ; 0163-4453
ISSN (online)	1532-2742
ISSN	0163-4453
DOI	10.1016/j.jinf.2024.106155
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Article ; Online: erm gene distribution among Norwegian Bacteroides isolates and evaluation of phenotypic tests to detect inducible clindamycin resistance in Bacteroides species.

Johnsen, Bjørn Odd / Handal, Nina / Meisal, Roger / Bjørnholt, Jørgen Vildershøj / Gaustad, Peter / Leegaard, Truls Michael

Anaerobe

2017 Volume 47, Page(s) 226–232

Abstract: The aims of this study were to describe the distribution of the most common erm genes in a collection of Norwegian Bacteroides isolates and to investigate whether the phenotypic tests for determining inducible clindamycin resistance among Bacteroides ... ...

Abstract	The aims of this study were to describe the distribution of the most common erm genes in a collection of Norwegian Bacteroides isolates and to investigate whether the phenotypic tests for determining inducible clindamycin resistance among Bacteroides species recommended by EUCAST, NordicAST and the manufacturer of E-test
Language	English
Publishing date	2017-10
Publishing country	England
Document type	Journal Article
ZDB-ID	1237621-8
ISSN	1095-8274 ; 1075-9964
ISSN (online)	1095-8274
ISSN	1075-9964
DOI	10.1016/j.anaerobe.2017.06.004
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Article ; Online: MRSA prevalence among healthcare personnel in contact tracings in hospitals.

Jørgensen, Silje B / Handal, Nina / Fjeldsæter, Kaja Linn / Kleppe, Lars Kåre / Myrbakk, Torni / Oma, Dorthea Hagen / Tveten, Yngvar / Walberg, Mette / Ørnevik, Grethe

Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke

2018 Volume 138, Issue 6

Abstract: Bakgrunn: I norsk helsevesen gjennomføres omfattende tiltak for å hindre spredning av meticillinresistente Staphylococcus aureus (MRSA). Vi ønsket å undersøke hvor mange smitteoppsporinger som gjøres rundt nyoppdagede MRSA-tilfeller hos pasienter og ... ...

Title translation	MRSA-forekomst blant helsepersonell ved smitteoppsporing i sykehus.
Abstract	Bakgrunn: I norsk helsevesen gjennomføres omfattende tiltak for å hindre spredning av meticillinresistente Staphylococcus aureus (MRSA). Vi ønsket å undersøke hvor mange smitteoppsporinger som gjøres rundt nyoppdagede MRSA-tilfeller hos pasienter og ansatte i sykehus, og hvor ofte smitteoppsporingene fører til ytterligere funn hos helsepersonell. Materiale og metode: I denne retrospektive observasjonsstudien bidro smittevernenhetene ved åtte helseforetak i landets fire helseregioner med opplysninger om MRSA-funn hos helsepersonell etter gjennomførte MRSA-smitteoppsporinger. Data ble innhentet fra 14 ulike somatiske sykehus i årene 2012-15. Resultater: 10 142 ansatte i helsevesenet ble testet for MRSA, med positivt funn hos 31 ansatte (0,31 %). Hos 19 ansatte (0,19 %) ble det påvist samme MRSA-stamme som hos indekskasus. I kun to av 351 smitteoppsporinger (0,57 %) ble samme MRSA-stamme funnet hos mer enn én ansatt. Fortolkning: MRSA-smitteoppsporing i norske sykehus har et betydelig omfang, men det er sjelden det påvises MRSA hos helsepersonell i forbindelse med smitteoppsporing.
MeSH term(s)	Carrier State/epidemiology ; Contact Tracing/statistics & numerical data ; Cross Infection/epidemiology ; Cross Infection/prevention & control ; Cross Infection/transmission ; Health Personnel/statistics & numerical data ; Hospitals ; Humans ; Infection Control ; Methicillin-Resistant Staphylococcus aureus/isolation & purification ; Norway/epidemiology ; Retrospective Studies ; Staphylococcal Infections/epidemiology ; Staphylococcal Infections/prevention & control ; Staphylococcal Infections/transmission
Language	Norwegian
Publishing date	2018-03-19
Publishing country	Norway
Document type	Journal Article ; Observational Study
ZDB-ID	603504-8
ISSN	0807-7096 ; 0029-2001
ISSN (online)	0807-7096
ISSN	0029-2001
DOI	10.4045/tidsskr.17.0364
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Zs.B 422: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Anaerobic blood culture isolates in a Norwegian university hospital: identification by MALDI-TOF MS vs 16S rRNA sequencing and antimicrobial susceptibility profiles.

Handal, Nina / Bakken Jørgensen, Silje / Smith Tunsjø, Hege / Johnsen, Bjørn Odd / Leegaard, Truls Michael

APMIS : acta pathologica, microbiologica, et immunologica Scandinavica

2015 Volume 123, Issue 9, Page(s) 749–758

Abstract: We investigated 197 anaerobic isolates recovered from blood cultures in the period 2009-2013. The isolates included were Bacteroides spp., Clostridium spp., Prevotella spp., Fusobacterium spp. and Gram-positive anaerobic cocci (GPAC). Identification ... ...

Abstract	We investigated 197 anaerobic isolates recovered from blood cultures in the period 2009-2013. The isolates included were Bacteroides spp., Clostridium spp., Prevotella spp., Fusobacterium spp. and Gram-positive anaerobic cocci (GPAC). Identification results by MALDI-TOF MS were compared to those obtained by 16S rRNA sequencing, and the MICs of benzylpenicillin, clindamycin, piperacillin-tazobactam, meropenem and metronidazole were determined by Etests. The MALDI-TOF MS correctly identified 94.9% of the anaerobes to the genus level, and 86.8% to the species level, with errors mainly among the non-fragilis Bacteroides spp. and GPAC. About 73.3% of the isolates were non-susceptible to penicillin, mainly due to high resistance rates in the Bacteroides spp. (99.2%) and Prevotella spp. (69.2%). About 18.5% of the isolates were clindamycin resistant. Piperacillin-tazobactam had an excellent activity against all anaerobes except the non-fragilis Bacteroides spp., of which 43.8% were non-susceptible. The clinical significance of such a high resistance rate is unclear. Meropenem and metronidazole were the most active antibiotics, with 96.9% and 97.9% of the isolates being susceptible.
MeSH term(s)	Anti-Infective Agents/therapeutic use ; Bacteria, Anaerobic/drug effects ; Bacteria, Anaerobic/isolation & purification ; Bacterial Infections/drug therapy ; Bacterial Infections/genetics ; Bacterial Infections/microbiology ; Hospitals, University ; Humans ; Microbial Sensitivity Tests/methods ; RNA, Ribosomal, 16S/genetics ; Sequence Analysis, RNA/methods ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization/methods
Chemical Substances	Anti-Infective Agents ; RNA, Ribosomal, 16S
Language	English
Publishing date	2015-09
Publishing country	Denmark
Document type	Journal Article
ZDB-ID	93340-5
ISSN	1600-0463 ; 0903-4641
ISSN (online)	1600-0463
ISSN	0903-4641
DOI	10.1111/apm.12410
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Article ; Online: Tuberkulose--den glemte delen av hivepidemien.

Trøseid, Marius / Handal, Nina / Holen, Øyunn

Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke

2007 Volume 127, Issue 20, Page(s) 2712–2714

Title translation	Tuberculosis--the forgotten part of the HIV epidemic.
MeSH term(s)	AIDS-Related Opportunistic Infections/diagnosis ; AIDS-Related Opportunistic Infections/drug therapy ; AIDS-Related Opportunistic Infections/epidemiology ; Antitubercular Agents/therapeutic use ; Developing Countries ; Disease Outbreaks ; Humans ; Tuberculosis/diagnosis ; Tuberculosis/drug therapy ; Tuberculosis/epidemiology ; Tuberculosis, Multidrug-Resistant/diagnosis ; Tuberculosis, Multidrug-Resistant/drug therapy ; Tuberculosis, Multidrug-Resistant/epidemiology
Chemical Substances	Antitubercular Agents
Language	Norwegian
Publishing date	2007-10-18
Publishing country	Norway
Document type	Journal Article
ZDB-ID	603504-8
ISSN	0807-7096 ; 0029-2001
ISSN (online)	0807-7096
ISSN	0029-2001
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Article ; Online: Stratification by interferon-γ release assay level predicts risk of incident TB.

Winje, Brita Askeland / White, Richard / Syre, Heidi / Skutlaberg, Dag Harald / Oftung, Fredrik / Mengshoel, Anne Torunn / Blix, Hege Salvesen / Brantsæter, Arne Broch / Holter, Ellen Kristine / Handal, Nina / Simonsen, Gunnar Skov / Afset, Jan Egil / Bakken Kran, Anne Marte

Thorax

2018

Abstract: Introduction: Targeted testing and treatment of latent TB infection (LTBI) are priorities on the global health agenda, but LTBI management remains challenging. We aimed to evaluate the prognostic value of the QuantiFERON TB-Gold (QFT) test for incident ... ...

Abstract	Introduction: Targeted testing and treatment of latent TB infection (LTBI) are priorities on the global health agenda, but LTBI management remains challenging. We aimed to evaluate the prognostic value of the QuantiFERON TB-Gold (QFT) test for incident TB, focusing on the interferon (IFN)-γ level, when applied in routine practice in a low TB incidence setting. Methods: In this large population-based prospective cohort, we linked QFT results in Norway (1 January 2009-30 June 2014) with national registry data (Norwegian Surveillance System for Infectious Diseases, Norwegian Prescription Database, Norwegian Patient Registry and Statistics Norway) to assess the prognostic value of QFT for incident TB. Participants were followed until 30 June 2016. We used restricted cubic splines to model non-linear relationships between IFN-γ levels and TB, and applied these findings to a competing risk model. Results: The prospective analyses included 50 389 QFT results from 44 875 individuals, of whom 257 developed TB. Overall, 22% (n=9878) of QFT results were positive. TB risk increased with the IFN-γ level until a plateau level, above which further increase was not associated with additional prognostic information. The HRs for TB were 8.8 (95% CI 4.7 to 16.5), 19.2 (95% CI 11.6 to 31.6) and 31.3 (95% CI 19.8 to 49.5) times higher with IFN-γ levels of 0.35 to <1.00, 1.00 to <4.00 and >4.00 IU/mL, respectively, compared with negative tests (<0.35 IU/mL). Conclusions: Consistently, QFT demonstrates increased risk of incident TB with rising IFN-γ concentrations, indicating that IFN-γ levels may be used to guide targeted treatment of LTBI.
Language	English
Publishing date	2018-04-05
Publishing country	England
Document type	Journal Article
ZDB-ID	204353-1
ISSN	1468-3296 ; 0040-6376
ISSN (online)	1468-3296
ISSN	0040-6376
DOI	10.1136/thoraxjnl-2017-211147
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Article ; Online: Clinical and bacteriological efficacy of pivmecillinam treatment for uncomplicated urinary tract infections caused by ESBL-producing Escherichia coli: a prospective, multicentre, observational cohort study.

Bollestad, Marianne / Grude, Nils / Solhaug, Sigrid / Raffelsberger, Niclas / Handal, Nina / Nilsen, Hans-Johnny Schjelderup / Romstad, Monica Regine / Emmert, Andreas / Tveten, Yngvar / Søraas, Arne / Jenum, Pål A / Jenum, Synne / Møller-Stray, Janne / Weme, Einar Tollaksen / Lindbaek, Morten / Simonsen, Gunnar Skov

The Journal of antimicrobial chemotherapy

2018 Volume 73, Issue 9, Page(s) 2503–2509

Abstract: Objectives: To compare the clinical and bacteriological outcomes of pivmecillinam treatment for community-acquired urinary tract infections (UTIs) caused by ESBL-producing Escherichia coli versus non-ESBL-producing E. coli in an outpatient setting.: ... ...

Abstract	Objectives: To compare the clinical and bacteriological outcomes of pivmecillinam treatment for community-acquired urinary tract infections (UTIs) caused by ESBL-producing Escherichia coli versus non-ESBL-producing E. coli in an outpatient setting. Methods: A prospective, multicentre, observational cohort study of women aged ≥16 years, with pivmecillinam-treated community-acquired UTIs caused by E. coli with or without ESBL production, recruited from primary care, was conducted in the period from April 2013 to August 2016. Eighty-eight women (mean age 49.4 years) with community-acquired UTIs caused by ESBL-producing E. coli were compared with a control group of 74 women (mean age 50.1 years). Trial registration: Regional Committees for Medical and Health Research Ethics (REC) in Norway, ID 2011/2214, and ClinicalTrials.gov, ID NCT01531023. Results: The median time until symptom resolution after treatment initiation was 5 days for the ESBL cases and 3 days for the non-ESBL controls (P < 0.01). The proportion of women warranting a second antibiotic prescription in the follow-up period was higher for the ESBL cases [30/88 (34.1%) versus 10/72 (13.9%), P < 0.01]. Persistent bacteriuria was non-significantly more common among ESBL cases than in the control group [15/81 (18.5%) versus 6/67 (9.0%), P = 0.10]. A pivmecillinam dosage of 200 mg given three times daily for ≤5 days was associated with treatment failure (OR 4.77, 95% CI 1.40-19.44, P = 0.03) for the ESBL E. coli group. For the subgroup treated with 400 mg of pivmecillinam given three times daily there was no significantly increased OR for treatment failure between ESBL cases and the control group irrespective of treatment duration. Conclusions: Pivmecillinam given at 400 mg three times daily gave comparable clinical and bacteriological cure rates in women with community-acquired E. coli UTIs irrespective of ESBL production.
MeSH term(s)	Adolescent ; Adult ; Aged ; Aged, 80 and over ; Amdinocillin Pivoxil/administration & dosage ; Anti-Infective Agents, Urinary/administration & dosage ; Escherichia coli/enzymology ; Escherichia coli/isolation & purification ; Escherichia coli Infections/drug therapy ; Escherichia coli Infections/microbiology ; Escherichia coli Infections/pathology ; Female ; Humans ; Middle Aged ; Norway ; Outpatients ; Prospective Studies ; Treatment Outcome ; Urinary Tract Infections/drug therapy ; Urinary Tract Infections/microbiology ; Urinary Tract Infections/pathology ; Young Adult ; beta-Lactamases/metabolism
Chemical Substances	Anti-Infective Agents, Urinary ; Amdinocillin Pivoxil (1WAM1OQ30B) ; beta-Lactamases (EC 3.5.2.6)
Language	English
Publishing date	2018-07-05
Publishing country	England
Document type	Journal Article ; Multicenter Study ; Observational Study ; Research Support, Non-U.S. Gov't
ZDB-ID	191709-2
ISSN	1460-2091 ; 0305-7453
ISSN (online)	1460-2091
ISSN	0305-7453
DOI	10.1093/jac/dky230
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