Annual Report of the Centre for Infectious Diseases Research, Diagnostics and Screening (IDS)

Veel (ziekenhuis)laboratoria sturen het te onderzoeken materiaal van patiënten naar het Centrum Infectieziekteonderzoek, diagnostiek en screening (IDS) van het RIVM. Dit betreft vooral bijzondere diagnostiek waarvoor de laboratoria zelf geen test in huis hebben. Ook komen patiëntmaterialen binnen om te monitoren of en in welke mate bepaalde ziekteverwekkende micro-organismen voorkomen. Soms worden de ziekteverwekkers zelf ingestuurd met de vraag of IDS deze wil karakteriseren. Met de verkregen resultaten houdt het RIVM er zicht op hoe vaak en waar bepaalde micro-organismen voorkomen. Op die manier kan het RIVM snel reageren op (plotselinge) ontwikkelingen op het gebied van infectieziekten. IDS beschrijft jaarlijks de resultaten om inzenders van patiëntmaterialen inzicht te geven in wat is gedaan aan diagnostiek, screening en onderzoek naar infectieziekten. De jaarrapportage 2015 beschrijft onder andere de bijdrage van IDS aan de ebola-diagnostiek in Sierra Leone. Zeven medewerkers hielpen ter plaatse door de laboratoriumdiagnostiek uit te voeren. Verder zijn bij IDS de eerste stappen gezet om de hielprikscreening uit te breiden, en wel met de screening op Severe combined immunodeficiency (SCID). Ook wordt toegelicht hoe het komt dat het griepvaccin in 2015 onvoldoende werkte. Een deel van de onder de bevolking circulerende influenzavirussen bleek af te wijken van de virussen die in het griepvaccin waren opgenomen. Het onderzoek bij IDS bestaat er vooral uit om innovatieve laboratoriumtesten te ontwikkelen, te verbeteren en in te zetten. Dit in het belang van de openbare gezondheidszorg. Bij veel van deze onderzoeken wordt een innovatieve methode gebruikt waarmee het hele genoom van een micro-organisme in kaart kan worden gebracht (Whole Genome sequencing).Many hospital and other laboratories send their patient materials to RIVM's Centre for Infectious Diseases Research, Diagnostics and Screening (IDS) for testing, particularly if special diagnostic procedures are required for which these laboratories lack the necessary testing facilities. Patient materials are also sent to IDS in order to monitor the incidence of specific pathogenic micro-organisms. In some cases the pathogens themselves are sent to IDS for characterization. The results obtained enable RIVM to keep track of where and how frequently specific micro-organisms occur, enabling RIVM to respond rapidly to any (sudden) developments relating to infectious diseases. IDS summarizes the results of these activities in an Annual Report to provide stakeholders with insight into infectious diseases research, diagnostics and screening. The topics covered in the Annual Report for 2015 include IDS's contribution to Ebola diagnostics in Sierra Leone. Seven staff members travelled to the West African nation to provide laboratory diagnostic assistance. In addition, IDS has taken initial steps to expand its heel prick screening programme to include Severe Combined Immune Deficiency syndrome (SCID). The report also explains why the Dutch flu vaccination programme was insufficiently effective in 2015. A part of the circulating influenza viruses in the human population was found to deviate from the viruses that were included in the flu vaccine. Research at IDS is mainly focused on developing, optimizing and implementing innovative laboratory tests that can help to improve public health. Much of its research uses Whole Genome Sequencing, an innovative laboratory process that determines the complete DNA sequence of a micro-organism's genome

Influence of population density on antibiotic resistance

Antibiotic consumption and population density as a measure of crowding in the community were related to the prevalence of antibiotic resistance of three cities in three different countries: St Johns in Newfoundland (Canada), Athens in Greece and Groningen in The Netherlands. Antibiotic consumption was expressed in DDD (defined daily dose), as DID (DDD/1000 inhabitants/day) and as DSD (DDD/km(2)). The prevalence of antibiotic-resistant Escherichia coli and enterococci was determined in faecal samples of healthy volunteers. In both Newfoundland (28 DID) and Greece (29 DID) the overall consumption of antibiotics was more than three times higher compared with that of The Netherlands (9 DID). The lowest prevalence of resistant E. coli against the majority of antibiotics tested was found for the samples from Newfoundland and was significant (P <0.05) for cefazolin, oxytetracycline and trimethoprim. A poor correlation between the number of DID and the prevalence of resistance was observed [the Pearson correlation coefficient (Pcc) ranged between -0.93 and 0.87]. However, when population density was taken into consideration and antibiotic consumption was expressed in DSD, a strong correlation was observed (and Pcc ranged between 0.86 and 1.00). This study suggests that population density is an important factor in the development of antibiotic resistance and warrants special attention as a factor in resistance epidemiology