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Article ; Online: Corrigendum: The impact of circadian rhythm on Bacillus Calmette-Guérin vaccination effects on SARS-CoV-2 infections.

Föhse, Konstantin / Taks, Esther J M / Moorlag, Simone J C F M / Bonten, Marc J M / van Crevel, Reinout / Ten Oever, Jaap / van Werkhoven, Cornelis H / Netea, Mihai G / van de Maat, Josephine S / Hoogerwerf, Jacobien J

Frontiers in immunology

2023 Volume 14, Page(s) 1208659

Abstract: This corrects the article DOI: 10.3389/fimmu.2023.980711.]. ...

Abstract	[This corrects the article DOI: 10.3389/fimmu.2023.980711.].
Language	English
Publishing date	2023-05-24
Publishing country	Switzerland
Document type	Published Erratum
ZDB-ID	2606827-8
ISSN	1664-3224 ; 1664-3224
ISSN (online)	1664-3224
ISSN	1664-3224
DOI	10.3389/fimmu.2023.1208659
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Article ; Online: The impact of circadian rhythm on Bacillus Calmette-Guérin vaccination effects on SARS-CoV-2 infections.

Frontiers in immunology

2023 Volume 14, Page(s) 980711

Abstract: Background and objective: A recent study has suggested that circadian rhythm has an important impact on the immunological effects induced by Bacillus Calmette-Guérin (BCG) vaccination. The objective of this study was to evaluate whether the timing of ... ...

Abstract	Background and objective: A recent study has suggested that circadian rhythm has an important impact on the immunological effects induced by Bacillus Calmette-Guérin (BCG) vaccination. The objective of this study was to evaluate whether the timing of BCG vaccination (morning or afternoon) affects its impact on severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infections and clinically relevant respiratory tract infections (RTIs). Methods: This is a Results: The subdistribution hazard ratio of SARS-CoV-2 infection in the first six months after vaccination was 2.394 (95% confidence interval [CI], 0.856-6.696) for the morning BCG group and 0.284 (95% CI, 0.055-1.480) for the afternoon BCG group. When comparing those two groups, the interaction hazard ratio was 8.966 (95% CI, 1.366-58.836). In the period from six months until 12 months after vaccination cumulative incidences of SARS-CoV-2 infection were comparable, as well as cumulative incidences of clinically relevant RTI in both periods. Conclusion: Vaccination with BCG in the afternoon offered better protection against SARS-CoV-2 infections than BCG vaccination in the morning in the first six months after vaccination.
MeSH term(s)	Aged ; Humans ; Middle Aged ; COVID-19 ; BCG Vaccine ; SARS-CoV-2 ; Circadian Rhythm ; Mycobacterium bovis ; Respiratory Tract Infections ; Vaccination
Chemical Substances	BCG Vaccine
Language	English
Publishing date	2023-02-16
Publishing country	Switzerland
Document type	Randomized Controlled Trial ; Multicenter Study ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2606827-8
ISSN	1664-3224 ; 1664-3224
ISSN (online)	1664-3224
ISSN	1664-3224
DOI	10.3389/fimmu.2023.980711
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Article ; Online: Bacillus Calmette-Guérin vaccine for prevention of COVID-19 and other respiratory tract infections in older adults with comorbidities: a randomized controlled trial.

Koekenbier, Eva L / Fohse, Konstantin / van de Maat, Josephine S / Oosterheert, Jan Jelrik / van Nieuwkoop, Cees / Hoogerwerf, Jacobien J / Grobusch, Martin P / van den Bosch, Maurice A A J / van de Wijgert, Janneke H H / Netea, Mihai G / Rosendaal, Frits R / Bonten, Marc J M / Werkhoven, C H Henri van

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

2023 Volume 29, Issue 6, Page(s) 781–788

Abstract: Objectives: To test whether Bacillus Calmette-Guérin (BCG) vaccination would reduce the incidence of COVID-19 and other respiratory tract infections (RTIs) in older adults with one or more comorbidities.: Methods: Community-dwelling adults aged 60 ... ...

Abstract	Objectives: To test whether Bacillus Calmette-Guérin (BCG) vaccination would reduce the incidence of COVID-19 and other respiratory tract infections (RTIs) in older adults with one or more comorbidities. Methods: Community-dwelling adults aged 60 years or older with one or more underlying comorbidities and no contraindications to BCG vaccination were randomized 1:1 to BCG or placebo vaccination and followed for 6 months. The primary endpoint was a self-reported, test-confirmed COVID-19 incidence. Secondary endpoints included COVID-19 hospital admissions and clinically relevant RTIs (i.e. RTIs including but not limited to COVID-19 requiring medical intervention). COVID-19 and clinically relevant RTI episodes were adjudicated. Incidences were compared using Fine-Gray regression, accounting for competing events. Results: A total of 6112 participants with a median age of 69 years (interquartile range, 65-74) and median of 2 (interquartile range, 1-3) comorbidities were randomized to BCG (n = 3058) or placebo (n = 3054) vaccination. COVID-19 infections were reported by 129 BCG recipients compared to 115 placebo recipients [hazard ratio (HR), 1.12; 95% CI, 0.87-1.44]. COVID-19-related hospitalization occurred in 18 BCG and 21 placebo recipients (HR, 0.86; 95% CI, 0.46-1.61). During the study period, 13 BCG recipients died compared with 18 placebo recipients (HR, 0.71; 95% CI, 0.35-1.43), of which 11 deaths (35%) were COVID-19-related: six in the placebo group and five in the BCG group. Clinically relevant RTI was reported by 66 BCG and 72 placebo recipients (HR, 0.92; 95% CI, 0.66-1.28). Discussion: BCG vaccination does not protect older adults with comorbidities against COVID-19, COVID-19 hospitalization, or clinically relevant RTIs.
MeSH term(s)	Humans ; Aged ; COVID-19/epidemiology ; COVID-19/prevention & control ; BCG Vaccine ; Vaccination ; Hospitalization ; Incidence
Chemical Substances	BCG Vaccine
Language	English
Publishing date	2023-02-02
Publishing country	England
Document type	Randomized Controlled Trial ; Journal Article
ZDB-ID	1328418-6
ISSN	1469-0691 ; 1470-9465 ; 1198-743X
ISSN (online)	1469-0691
ISSN	1470-9465 ; 1198-743X
DOI	10.1016/j.cmi.2023.01.019
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Article ; Online: Metabolic adaptations of human alveolar macrophages upon activation by lipopolysaccharide in vivo.

Otto, Natasja A / Butler, Joe M / Ramirez-Moral, Ivan / Hoogerwerf, Jacobien J / Houtkooper, Riekelt H / de Vos, Alex F / van der Poll, Tom

Scandinavian journal of immunology

2021 Volume 93, Issue 4, Page(s) e13011

MeSH term(s)	Bronchoalveolar Lavage Fluid ; Humans ; Lipopolysaccharides ; Macrophages, Alveolar ; Tumor Necrosis Factor-alpha
Chemical Substances	Lipopolysaccharides ; Tumor Necrosis Factor-alpha
Language	English
Publishing date	2021-01-05
Publishing country	England
Document type	Letter ; Comment
ZDB-ID	120476-2
ISSN	1365-3083 ; 0300-9475
ISSN (online)	1365-3083
ISSN	0300-9475
DOI	10.1111/sji.13011
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Article ; Online: Few bacterial co-infections but frequent empiric antibiotic use in the early phase of hospitalized patients with COVID-19: results from a multicentre retrospective cohort study in The Netherlands.

Karami, Zara / Knoop, Bram T / Dofferhoff, Anton S M / Blaauw, Marc J T / Janssen, Nico A / van Apeldoorn, Marjan / Kerckhoffs, Angèle P M / van de Maat, Josephine S / Hoogerwerf, Jacobien J / Ten Oever, Jaap

Infectious diseases (London, England)

2020 Volume 53, Issue 2, Page(s) 102–110

Abstract: Background: Knowledge on bacterial co-infections in COVID-19 is crucial to use antibiotics appropriately. Therefore, we aimed to determine the incidence of bacterial co-infections, antibiotic use and application of antimicrobial stewardship principles ... ...

Abstract	Background: Knowledge on bacterial co-infections in COVID-19 is crucial to use antibiotics appropriately. Therefore, we aimed to determine the incidence of bacterial co-infections, antibiotic use and application of antimicrobial stewardship principles in hospitalized patients with COVID-19. Methods: We performed a retrospective observational study in four hospitals (1 university, 2 non-university teaching, 1 non-teaching hospital) in the Netherlands from March to May 2020 including consecutive patients with PCR-confirmed COVID-19. Data on first microbiological investigations obtained at the discretion of the physician and antibiotic use in the first week of hospital admission were collected. Results: Twelve (1.2%) of the 925 patients included had a documented bacterial co-infection (75.0% pneumonia) within the first week. Microbiological testing was performed in 749 (81%) patients: sputum cultures in 105 (11.4%), blood cultures in 711 (76.9%), pneumococcal urinary antigen testing in 202 (21.8%), and Conclusions: On presentation to the hospital bacterial co-infections are rare, while empiric antibiotic use is abundant. This implies that in patients with COVID-19 empiric antibiotic should be withheld. This has the potential to dramatically reduce the current overuse of antibiotics in the COVID-19 pandemic.
MeSH term(s)	Aged ; Anti-Bacterial Agents/administration & dosage ; Antimicrobial Stewardship ; Bacterial Infections/drug therapy ; Bacterial Infections/epidemiology ; Bacterial Infections/microbiology ; Blood Culture ; COVID-19/epidemiology ; COVID-19/virology ; Coinfection ; Drug Administration Routes ; Drug Administration Schedule ; Female ; Guideline Adherence/statistics & numerical data ; Hospitalization ; Humans ; Incidence ; Male ; Middle Aged ; Netherlands/epidemiology ; Pandemics ; Prescription Drug Overuse/prevention & control ; Prescription Drug Overuse/statistics & numerical data ; Retrospective Studies ; SARS-CoV-2/pathogenicity
Chemical Substances	Anti-Bacterial Agents
Keywords	covid19
Language	English
Publishing date	2020-10-24
Publishing country	England
Document type	Journal Article ; Multicenter Study ; Observational Study
ZDB-ID	2839775-7
ISSN	2374-4243 ; 2374-4235
ISSN (online)	2374-4243
ISSN	2374-4235
DOI	10.1080/23744235.2020.1839672
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Article ; Online: The 2021 Dutch Working Party on Antibiotic Policy (SWAB) guidelines for empirical antibacterial therapy of sepsis in adults.

Sieswerda, Elske / Bax, Hannelore I / Hoogerwerf, Jacobien J / de Boer, Mark G J / Boermeester, Marja / Bonten, Marc J M / Dekker, Douwe / van Wijk, Roy Gerth / Juffermans, Nicole P / Kuindersma, Marnix / van der Linden, Paul D / Melles, Damian C / Pickkers, Peter / Schouten, Jeroen A / Rebel, Jasper R / van Zanten, Arthur R H / Prins, Jan M / Wiersinga, W Joost

BMC infectious diseases

2022 Volume 22, Issue 1, Page(s) 687

Abstract: Background: The Dutch Working Party on Antibiotic Policy (SWAB) in collaboration with relevant professional societies, has updated their evidence-based guidelines on empiric antibacterial therapy of sepsis in adults.: Methods: Our multidisciplinary ... ...

Abstract	Background: The Dutch Working Party on Antibiotic Policy (SWAB) in collaboration with relevant professional societies, has updated their evidence-based guidelines on empiric antibacterial therapy of sepsis in adults. Methods: Our multidisciplinary guideline committee generated ten population, intervention, comparison, and outcome (PICO) questions relevant for adult patients with sepsis. For each question, a literature search was performed to obtain the best available evidence and assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. The quality of evidence for clinically relevant outcomes was graded from high to very low. In structured consensus meetings, the committee formulated recommendations as strong or weak. When evidence could not be obtained, recommendations were provided based on expert opinion and experience (good practice statements). Results: Fifty-five recommendations on the antibacterial therapy of sepsis were generated. Recommendations on empiric antibacterial therapy choices were differentiated for sepsis according to the source of infection, the potential causative pathogen and its resistance pattern. One important revision was the distinction between low, increased and high risk of infection with Enterobacterales resistant to third generation cephalosporins (3GRC-E) to guide the choice of empirical therapy. Other new topics included empirical antibacterial therapy in patients with a reported penicillin allergy and the role of pharmacokinetics and pharmacodynamics to guide dosing in sepsis. We also established recommendations on timing and duration of antibacterial treatment. Conclusions: Our multidisciplinary committee formulated evidence-based recommendations for the empiric antibacterial therapy of adults with sepsis in The Netherlands.
MeSH term(s)	Adult ; Anti-Bacterial Agents/therapeutic use ; Humans ; Netherlands ; Policy ; Sepsis/drug therapy
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2022-08-11
Publishing country	England
Document type	Journal Article
ZDB-ID	2041550-3
ISSN	1471-2334 ; 1471-2334
ISSN (online)	1471-2334
ISSN	1471-2334
DOI	10.1186/s12879-022-07653-3
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Article ; Online: The impact of BNT162b2 mRNA vaccine on adaptive and innate immune responses.

Föhse, Konstantin / Geckin, Büsra / Zoodsma, Martijn / Kilic, Gizem / Liu, Zhaoli / Röring, Rutger J / Overheul, Gijs J / van de Maat, Josephine / Bulut, Ozlem / Hoogerwerf, Jacobien J / Ten Oever, Jaap / Simonetti, Elles / Schaal, Heiner / Adams, Ortwin / Müller, Lisa / Ostermann, Philipp Niklas / van de Veerdonk, Frank L / Joosten, Leo A B / Haagmans, Bart L /

van Crevel, Reinout / van Rij, Ronald P / GeurtsvanKessel, Corine / de Jonge, Marien I / Li, Yang / Domínguez-Andrés, Jorge / Netea, Mihai G

Clinical immunology (Orlando, Fla.)

2023 Volume 255, Page(s) 109762

Abstract: The mRNA-based BNT162b2 protects against severe disease and mortality caused by SARS-CoV-2 via induction of specific antibody and T-cell responses. Much less is known about its broad effects on immune responses against other pathogens. Here, we ... ...

Abstract	The mRNA-based BNT162b2 protects against severe disease and mortality caused by SARS-CoV-2 via induction of specific antibody and T-cell responses. Much less is known about its broad effects on immune responses against other pathogens. Here, we investigated the adaptive immune responses induced by BNT162b2 vaccination against various SARS-CoV-2 variants and its effects on the responsiveness of immune cells upon stimulation with heterologous stimuli. BNT162b2 vaccination induced effective humoral and cellular immunity against SARS-CoV-2 that started to wane after six months. We also observed long-term transcriptional changes in immune cells after vaccination. Additionally, vaccination with BNT162b2 modulated innate immune responses as measured by inflammatory cytokine production after stimulation - higher IL-1/IL-6 release and decreased IFN-α production. Altogether, these data expand our knowledge regarding the overall immunological effects of this new class of vaccines and underline the need for additional studies to elucidate their effects on both innate and adaptive immune responses.
Language	English
Publishing date	2023-09-06
Publishing country	United States
Document type	Journal Article
ZDB-ID	1459903-x
ISSN	1521-7035 ; 1521-6616
ISSN (online)	1521-7035
ISSN	1521-6616
DOI	10.1016/j.clim.2023.109762
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Article ; Online: New clinical prediction model for early recognition of sepsis in adult primary care patients: a prospective diagnostic cohort study of development and external validation.

Loots, Feike J / Smits, Marleen / Hopstaken, Rogier M / Jenniskens, Kevin / Schroeten, Fleur H / van den Bruel, Ann / van de Pol, Alma C / Oosterheert, Jan Jelrik / Bouma, Hjalmar / Little, Paul / Moore, Michael / van Delft, Sanne / Rijpsma, Douwe / Holkenborg, Joris / van Bussel, Bas Ct / Laven, Ralph / Bergmans, Dennis Cjj / Hoogerwerf, Jacobien J / Latten, Gideon Hp /

de Bont, Eefje Gpm / Giesen, Paul / Harder, Annemarie den / Kusters, Ron / van Zanten, Arthur Rh / Verheij, Theo Jm

The British journal of general practice : the journal of the Royal College of General Practitioners

2022 Volume 72, Issue 719, Page(s) e437–e445

Abstract: Background: Recognising patients who need immediate hospital treatment for sepsis while simultaneously limiting unnecessary referrals is challenging for GPs.: Aim: To develop and validate a sepsis prediction model for adult patients in primary care.!# ...

Abstract	Background: Recognising patients who need immediate hospital treatment for sepsis while simultaneously limiting unnecessary referrals is challenging for GPs. Aim: To develop and validate a sepsis prediction model for adult patients in primary care. Design and setting: This was a prospective cohort study in four out-of-hours primary care services in the Netherlands, conducted between June 2018 and March 2020. Method: Adult patients who were acutely ill and received home visits were included. A total of nine clinical variables were selected as candidate predictors, next to the biomarkers C-reactive protein, procalcitonin, and lactate. The primary endpoint was sepsis within 72 hours of inclusion, as established by an expert panel. Multivariable logistic regression with backwards selection was used to design an optimal model with continuous clinical variables. The added value of the biomarkers was evaluated. Subsequently, a simple model using single cut-off points of continuous variables was developed and externally validated in two emergency department populations. Results: A total of 357 patients were included with a median age of 80 years (interquartile range 71-86), of which 151 (42%) were diagnosed with sepsis. A model based on a simple count of one point for each of six variables (aged >65 years; temperature >38°C; systolic blood pressure ≤110 mmHg; heart rate >110/min; saturation ≤95%; and altered mental status) had good discrimination and calibration (C-statistic of 0.80 [95% confidence interval = 0.75 to 0.84]; Brier score 0.175). Biomarkers did not improve the performance of the model and were therefore not included. The model was robust during external validation. Conclusion: Based on this study's GP out-of-hours population, a simple model can accurately predict sepsis in acutely ill adult patients using readily available clinical parameters.
MeSH term(s)	Adult ; Aged, 80 and over ; Biomarkers ; Cohort Studies ; Humans ; Models, Statistical ; Primary Health Care ; Prognosis ; Prospective Studies ; Sepsis/diagnosis
Chemical Substances	Biomarkers
Language	English
Publishing date	2022-05-26
Publishing country	England
Document type	Journal Article
ZDB-ID	1043148-2
ISSN	1478-5242 ; 0035-8797 ; 0960-1643
ISSN (online)	1478-5242
ISSN	0035-8797 ; 0960-1643
DOI	10.3399/BJGP.2021.0520
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Article: Few bacterial co-infections but frequent empiric antibiotic use in the early phase of hospitalized patients with COVID-19: results from a multicentre retrospective cohort study in The Netherlands

Infect Dis (Lond)

Abstract: BACKGROUND: Knowledge on bacterial co-infections in COVID-19 is crucial to use antibiotics appropriately. Therefore, we aimed to determine the incidence of bacterial co-infections, antibiotic use and application of antimicrobial stewardship principles in ...

Abstract	BACKGROUND: Knowledge on bacterial co-infections in COVID-19 is crucial to use antibiotics appropriately. Therefore, we aimed to determine the incidence of bacterial co-infections, antibiotic use and application of antimicrobial stewardship principles in hospitalized patients with COVID-19. METHODS: We performed a retrospective observational study in four hospitals (1 university, 2 non-university teaching, 1 non-teaching hospital) in the Netherlands from March to May 2020 including consecutive patients with PCR-confirmed COVID-19. Data on first microbiological investigations obtained at the discretion of the physician and antibiotic use in the first week of hospital admission were collected. RESULTS: Twelve (1.2%) of the 925 patients included had a documented bacterial co-infection (75.0% pneumonia) within the first week. Microbiological testing was performed in 749 (81%) patients: sputum cultures in 105 (11.4%), blood cultures in 711 (76.9%), pneumococcal urinary antigen testing in 202 (21.8%), and Legionella urinary antigen testing in 199 (21.5%) patients, with clear variation between hospitals. On presentation 556 (60.1%; range 33.3-73.4%) patients received antibiotics for a median duration of 2 days (IQR 1-4). Intravenous to oral switch was performed in 41 of 413 (9.9%) patients who received intravenous treatment >48 h. Mean adherence to the local guideline on empiric antibiotic therapy on day 1 was on average 60.3% (range 45.3%-74.7%). CONCLUSIONS: On presentation to the hospital bacterial co-infections are rare, while empiric antibiotic use is abundant. This implies that in patients with COVID-19 empiric antibiotic should be withheld. This has the potential to dramatically reduce the current overuse of antibiotics in the COVID-19 pandemic.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #889455
Database	COVID19

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Article ; Online: Few bacterial co-infections but frequent empiric antibiotic use in the early phase of hospitalized patients with COVID-19

Karami, Zara / Knoop, Bram T. / Dofferhoff, Anton S. M. / Blaauw, Marc J. T. / Janssen, Nico A. / van Apeldoorn, Marjan / Kerckhoffs, Angèle P. M. / van de Maat, Josephine S. / Hoogerwerf, Jacobien J. / ten Oever, Jaap

Infectious Diseases

results from a multicentre retrospective cohort study in The Netherlands

2020 , Page(s) 1–9

Keywords	Microbiology (medical) ; General Immunology and Microbiology ; Infectious Diseases ; General Medicine ; covid19
Language	English
Publisher	Informa UK Limited
Publishing country	uk
Document type	Article ; Online
ZDB-ID	2839775-7
ISSN	2374-4243 ; 2374-4235
ISSN (online)	2374-4243
ISSN	2374-4235
DOI	10.1080/23744235.2020.1839672
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