Prevalence and mechanisms of resistance to carbapenems in Enterobacteriaceae

Objectives: To determine the point prevalence of carbapenem-non-susceptible Enterobacteriaceae (CNSE) and carbapenemase-producing Enterobacteriaceae (CPE) isolates among hospitalized patients in Belgium. Methods: Twenty-four hospital-based laboratories prospectively collected 200 non-duplicated Enterobacteriaceae isolates from clinical specimens of hospitalized patients over a 2 month period. All isolates were screened locally for decreased susceptibility to carbapenem drugs using a disc diffusion method according to CLSI interpretative criteria. CNSE strains were referred centrally for confirmation of carbapenemase by phenotypic and molecular testing. Results: From February to April 2012, 158 of the 4564 screened Enterobacteriaceae isolates were categorized as non-susceptible to carbapenems, resulting in a point prevalence of CNSE of 3.5% (95% CI: 2.9%–4.2%; range per centre: 0.5%–8.5%). Of the 125 referred CNSE isolates, 11 Klebsiella pneumoniae isolates [OXA-48 (n=7), KPC type (n=3) and NDM type (n=1)], 1 OXA-48-positive Escherichia coli isolate and 1 KPC-positive Klebsiella oxytoca isolate were detected in eight hospitals. None of the 72 carbapenem-non-susceptible Enterobacter spp. isolates were confirmed as CPE. The minimal estimated point prevalence of CPE isolates was 0.28% (13/ 4564; 95% CI: 0.13%–0.44%) overall (range per centre: 0%–1.5%). Conclusions: Despite the overall low prevalence of CNSE found in this study, the detection of CPE isolates in one-third of the participating centres raises concerns and highly suggests the spread and establishment of CPE in Belgian hospitals

Does more knowledge about the European Union lead to a stronger European citizenship? A comparative research among adolescents in 21 European member states

Strengthening European citizenship is often considered as a ‘cure’ for the democratic deficit and the lack of legitimacy of the European Union (European Commission, 2001; Habermas, 2011). We distinguish two possible ways to strengthen citizenship: a cognitive one (more knowledge about the EU leads to a stronger citizenship) and a utilitarian one (inhabitants of countries that benefit more from their EU-membership have a stronger feeling of European citizenship). We apply a multilevel analysis on the results of the International Civic and Citizenship Education Study to test both explanatory models. 70,502 adolescents from 21 European member states were questioned in this study. The analysis shows that knowledge about the EU only has a limited effect on European citizenship. The degree in which a member state contributes to the European budget doesn’t seem to have an effect on the strength of European citizenship. The analysis rather shows that trust in national political institutions is the most important determinant for the development of European citizenship. We conclude with several possible explanations for the relation between political trust and the legitimacy of multilevel government within the European Union, which could lead to future research.peerreview_statement: The publishing and review policy for this title is described in its Aims & Scope. aims_and_scope_url: http://www.tandfonline.com/action/journalInformation?show=aimsScope&journalCode=ciej20status: publishe

Leidt meer kennis over de Europese Unie tot een sterkere Europese identiteit? Een vergelijkend onderzoek bij adolescenten in 21 lidstaten

Strengthening European citizenship is often considered as a ‘cure’ for the democratic defi cit and the lack of legitimacy of the European Union (European Commission, 2001; Habermas, 2011). The present research focuses on the identity component of European citizenship, which is a core component of European citizenship. We distinguish two possible ways to strengthen European identity: a cognitive one (more knowledge about the EU leads to a stronger identity) and a utilitarian one (living in a member state that benefi ts more from its EU-membership leads to a stronger European identity). We test both explanatory models using a multilevel analysis on the data of the International Civic and Citizenship Education Study. 70,502 adolescents from 21 European member states were questioned in this study. Results indicate that knowledge about the EU only has a limited effect on European identity. The degree in which a member state contributes to the European budget does not seem to have an effect on the strength of European identity at all.status: publishe

Does more knowledge about the European Union lead to a stronger European identity? A comparative research among adolescents in 21 European member states

Strengthening European identity is often considered as a ‘cure’ for the democratic deficit and the lack of legitimacy of the European Union (European Commission, 2001; Habermas, 2011). We distinguish two possible ways to strengthen European identity: a cognitive one (more knowledge about the EU leads to a stronger identity) and a utilitarian one (inhabitants of countries that benefit more from their EU-membership have a stronger feeling of European identity). We apply a multilevel analysis on the results of the International Civic and Citizenship Education Study to test both explanatory models. 70,502 adolescents from 21 European member states were questioned in this study. The analysis shows that knowledge about the EU only has a limited effect on European identity. The degree in which a member state contributes to the European budget doesn’t seem to have an effect on the strength of European identity. The analysis rather shows that trust in national political institutions is the most important determinant for the development of European identity and that, on the country-level, a more Eurosceptic climate makes this European identity weaker.status: publishe