Diagnostic issues and capabilities in 48 isolation facilities in 16 European countries: data from EuroNHID surveys

Background: Highly infectious diseases (HIDs) are defined as being transmissible from person to person, causing life-threatening illnesses and presenting a serious public health hazard. The sampling, handling and transport of specimens from patients with HIDs present specific bio-safety concerns. Findings The European Network for HID project aimed to record, in a cross-sectional study, the infection control capabilities of referral centers for HIDs across Europe and assesses the level of achievement to previously published guidelines. In this paper, we report the current diagnostic capabilities and bio-safety measures applied to diagnostic procedures in these referral centers. Overall, 48 isolation facilities in 16 European countries were evaluated. Although 81% of these referral centers are located near a biosafety level 3 laboratory, 11% and 31% of them still performed their microbiological and routine diagnostic analyses, respectively, without bio-safety measures. Conclusions: The discrepancies among the referral centers surveyed between the level of practices and the European Network of Infectious Diseases (EUNID) recommendations have multiple reasons of which the interest of the individuals in charge and the investment they put in preparedness to emerging outbreaks. Despite the fact that the less prepared centers can improve by just updating their practice and policies any support to help them to achieve an acceptable level of biosecurity is welcome

Antiretrovirale Therapie der HIV-Infektion

Die antiretrovirale Therapie der HIV-Infektion hat sich in den letzten zwei Jahren aufgrund neuer Therapieoptionen und -strategien deutlich gewandelt. Die Empfehlungen zur antiretroviralen Therapie wurden daher in Abhängigkeit von klinischen, immunologischen und virologischen Parametern von einem deutsch-österreichischen Expertengremium überarbeitet. Eingebrachte Studienergebnisse betreffen insbesondere die Wertung der Kombinationstherapien von zwei nukleosidanalogen reverse Transkriptase-Inhibitoren (NRTI) in Kombination mit einem nichtnukleosidanalogen reverse Transkriptase-Inhibitor (NNRTI) oder einem Proteaseinhibitor und mit drei NRTI. Diese Kombinationen werden hinsichtlich ihrer therapeutischen Effektivität und ihres Nebenwirkungsprofils gewichtet. Für eine effektive Therapie sind eine Resistenztestung und eine Bestimmung von Plasmamedikamentenspiegeln bedeutsame Parameter, die für das Monitoring wichtig sind, sowie Faktoren, die einen Wechsel und eine Unterbrechung der Therapie indizieren, werden aufgezeigt.Antiretroviral Therapy in HIV-Infections During the last two years, antiretroviral therapy of HIV infections has changed dramatically. Therefore a board of German and Austrian physicians experienced in antiretroviral research and HIV patient care revised the guidelines for antiretroviral therapy and treatment and have strongly been influenced by data from latest studies on clinical, immunological and viral parameters. These studies mainly investigated combination therapies such as two nucleoside reverse transcritase inhibitor (NRTI) with one protease inhibitor or one non-nucleoside reverse transcriptase inhibitor with three NRTI. These combination therapies are evaluated in regard to their therapeutic effectiveness and their side effects. Resistance testing and drug monitoring are most important during therapy. Parameters which necessitate a change in or interruption of therapy are discussed

Diagnostic issues and capabilities in 48 isolation facilities in 16 European countries: data from EuroNHID surveys

Abstract Background Highly infectious diseases (HIDs) are defined as being transmissible from person to person, causing life-threatening illnesses and presenting a serious public health hazard. The sampling, handling and transport of specimens from patients with HIDs present specific bio-safety concerns. Findings The European Network for HID project aimed to record, in a cross-sectional study, the infection control capabilities of referral centers for HIDs across Europe and assesses the level of achievement to previously published guidelines. In this paper, we report the current diagnostic capabilities and bio-safety measures applied to diagnostic procedures in these referral centers. Overall, 48 isolation facilities in 16 European countries were evaluated. Although 81% of these referral centers are located near a biosafety level 3 laboratory, 11% and 31% of them still performed their microbiological and routine diagnostic analyses, respectively, without bio-safety measures. Conclusions The discrepancies among the referral centers surveyed between the level of practices and the European Network of Infectious Diseases (EUNID) recommendations have multiple reasons of which the interest of the individuals in charge and the investment they put in preparedness to emerging outbreaks. Despite the fact that the less prepared centers can improve by just updating their practice and policies any support to help them to achieve an acceptable level of biosecurity is welcome.</p