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Monique M Elseviers

Publications and source records attributed to Monique M Elseviers.

11 recordsLinked to original sources
PubMed2007

Antibiotic use in ambulatory care in Europe (ESAC data 1997-2002): trends, regional differences and seasonal fluctuations.

PURPOSE: The ESAC project (European Study on Antibiotic Consumption) aims to collect antibiotic-use data through a European network of national surveillance systems. This paper reports on the retrospective data collection in ambulatory care for the period 1997-2002. METHODS: Valid data of antibiotic consumption of 24 European countries for 2002 and of 18 countries for the entire 6-year period was classified according to the Anatomical Therapeutic Chemical Classification (ATC) and expressed in defined daily dose (DDD) per 1000 inhabitants per day (DID). Overall and subgroup comparison of antibiotic consumption over time as well as between geographical clusters was performed. RESULTS: Total use of antibiotics in Europe remained at a median level of 20 DID in the period 1997-2002 with a wide variation between countries ranging from 9.8 DID in The Netherlands to 32.2 DID in France. A substantial increase in subclass consumption of co-amoxiclav and fluoroquinolones was noted while the use of narrow-spectrum penicillins, erythromycin, quinolones and sulfonamides decreased. Total consumption as well as seasonal fluctuations showed remarkable geographical clustering with low consumption and low variation between summer and winter in the North, high consumption patterns in the South and a mixed model in the East. CONCLUSIONS: Within the ESAC project, valid time series of antibiotic-use data are publicly available now, enabling to improve the study of determinants of use, the evaluation of governmental antibiotic consumption policies and the investigation of the associated emergence of antibiotic resistance.

Ambulatory Care↗
PubMed2003

Herpes simplex virus in the respiratory tract of critical care patients: a prospective study.

BACKGROUND: Herpes simplex virus (HSV) is occasionally detected in the lower respiratory tract of patients in intensive care, but its clinical importance in such situations remains unclear. We did a prospective cohort study to define the prevalence, origin, risk factors, and clinical relevance of HSV in the respiratory tract of patients undergoing critical care. METHODS: We tested 764 patients admitted to intensive care for the presence of HSV in the respiratory tract, and assessed statistical relations between this virus and clinical variables. FINDINGS: HSV was detected by oropharyngeal swab in the upper respiratory tract of 169 (22%) of 764 patients, within 10 days of admission for 150 (89%) of these individuals. The virus was isolated in 58 (16%) of 361 patients whose lower respiratory tract was sampled. The presence of HSV in the throat was a risk factor for development of HSV infections in the lower respiratory tract (p<0.001). HSV was isolated most frequently in patients with severe disease. HSV in the throat was associated with acute respiratory distress syndrome (p<0.001) and with increased length of stay in intensive care (p<0.001). INTERPRETATION: Our data suggest that HSV reactivation or infection of the upper respiratory tract is frequent among patients in intensive care, and is a risk factor for development of lower respiratory tract infection with this virus, possibly by means of aspiration.

Adolescent↗
PubMed2003

Identifying vascular access complications among ESRD patients in Europe. A prospective, multicenter study.

The pilot project of the Research Board of the EDTNA/ERCA was aimed at reviewing the management of vascular access (VA) in European dialysis centres (see August 1999 NN&I). In Part 1 of this study, centre policies related to VA management were investigated. In Part 2, detailed in this article, individual patients were prospectively followed for one year to identify VA-related complications. A cohort of 1,380 adult patients randomly selected from 47 centres in 16 European countries was followed for one year using a computerised data collection system. Data were collected at baseline after 6 and 12 months and each time a VA complication occurred. At the start of the observation period, 77% of patients had a native arteriovenous (AV) fistula, 10% had an AV graft, and 13% had a catheter for access. A total of 489 complications were noted during the one-year period. Most frequently observed were thrombosis, stenosis, infection, bleeding, and flow problems. Hospitalisation (mean duration = 6.2 days) was required in 39% of patients with complications, and 29% of complications resulted in a definitive loss of VA. Complications were more frequently observed in patients with catheters (27%) and AV grafts (37%) compared to those with an AV fistula (15%). The risk of thrombosis was more than four times higher and the risk of bleeding was more than six times higher if an AV graft was used compared to an AV fistula. Catheters presented an eightfold increased risk for patients of developing infections and access flow problems. [figure: see text] This study revealed the high complication rate in VA and strengthened the notion that the AV fistula is the superior access.

Adolescent↗
PubMed2002

Decreased short-term renal graft survival in Maghrebian recipients.

The influence of race on renal allograft survival is disputed. We studied 16 cadaveric renal transplants in 14 Maghrebian patients, each matched with two controls of local origin. Patient survival at 12 months was 93% in the Maghreb group and 97% in the control group (NS). Graft survivals at 3 months for these two groups were 73% and 97%, respectively (P<0.01). At 6 months, graft survival in the control group remained unchanged at 97%, whereas in the case group it declined further to 59% (P<0.01). Overall graft failure in the Maghreb group amounted to 44% (seven of 16 transplants). In each case, failure was due to biopsy-proven acute rejection. Overall graft failure amongst the controls was only 6% (two of 32 transplants) (P=0.004) (only one case of acute rejection, or 3%) (P=0.01). This study provides evidence for significantly lower short-term renal graft survival in Maghrebian recipients of a Caucasian graft. Acute rejection seems to play a major causative role in graft loss in this group.

Adult↗
PubMedDate not supplied

Information and counselling for patients approaching end-stage renal failure in selected centres across Europe.

The EDTNA/ERCA survey of the provision of pre-ESRF information, education and counselling in renal care was the third project organised through the Collaborative Research Programme (CRP). Data was collected from 35 participating centres in 10 countries. The majority of participating centres had a structured pre-ESRF programme. Advice and education received by patients in these centres was usually provided by a multidisciplinary team and was coordinated by nurses in half of the centres. Programmes in all countries had similar content in that normal kidney function, medication, diet, haemodialysis, peritoneal dialysis and transplantation were routinely discussed and that issues such as employment, importance of leisure activities, holidays and Kidney Patient Associations were also on the agenda for discussion. Educational material produced by companies was widely used. Policy differences did emerge in attitudes to discussing the "no-treatment" option with patients accepted for dialysis and in the treatment that would be offered to patients with specific co-morbidities and life-style.

Adult↗
PubMedDate not supplied

Complications of vascular access: results of a European multi centre study of the EDTNA/ERCA Research Board.

The pilot project of the Research Board of EDTNA/ERCA handled the management of vascular accesses (VA) in European dialysis centres. In the first part of the study, centre policies related to VA management were investigated. In the second part of the study, individual patients were followed prospectively during one year. This paper reports on several topics of the second part of the project, investigating complications of the VA related to centre, patient characteristics and dialysis techniques used. Complications most frequently observed were thrombosis, stenosis, infection, bleeding and flow problems. Gradually more infections and flow problems were observed if the centre size and the patients/nurse ratio went up. Complication rate was not significantly influenced by age, gender, renal diagnosis, time on dialysis or medication used by the patient. In contrast, the number of vascular accesses in the past and interventions in the VA before first use resulted in an increased number of complications. Nurses have a key role in the prevention, manipulation and outcome of vascular access related complications.

Adolescent↗