PubMed · 11637161
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S Andersen. 1983. [Not Available].. https://pubmed.ncbi.nlm.nih.gov/11637161/
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BACKGROUNDIncreasing incidence rates of invasive Streptococcus dysgalactiae subspecies equisimilis (iSDSE) have been detected worldwide.AIMWe aimed to investigate iSDSE infection incidence rates in Denmark during 2014-2024, and characterise the genomic population structure of a subset of iSDSE isolates and their antimicrobial resistance (AMR).METHODSUsing national register data, we estimated overall and sex-/age-stratified iSDSE incidences during 2014-2024, by retrospectively identifying cases of invasive infections with group C and G streptococci or S. dysgalactiae (including specified as subspecies equisimilis). From the voluntary national beta-haemolytic streptococci laboratory surveillance system, whole-genome-sequenced isolates from August 2020-September 2022 were used to investigate the iSDSE genomic population structure. Susceptibility to penicillin, erythromycin and clindamycin was determined and AMR genes identified.RESULTSDuring 2014-2024, iSDSE incidence rates increased significantly (linear trend analysis p < 0.001) with mean annual incidence ranging between 10.3 and 16.4 per 100,000, peaking in 2023. Incidence was higher in males, increasing with older age. Nearly 75% of the 1,223 iSDSE isolates belonged to four of 14 genetic clusters. Sequence types (STs) ST20 and ST17 were most prevalent, while emm-type stG62647, a variant associated internationally with higher virulence, dominated. All isolates were phenotypically susceptible to penicillin but approximately 10% were respectively erythromycin and clindamycin resistant. High erythromycin resistance prevalence (57%; 39/68), coinciding with gene ermA, occurred in one genetic cluster.CONCLUSIONThe findings illustrate the need for national registry-based surveillance to detect epidemiological changes and potential outbreaks. Further, continuous genomic surveillance can monitor the occurrence and expansion of genetic clades and AMR genes.
INTRODUCTION: The relation between the length of stay after admission to a medical ward, the available resources, and the quality of the results is not well established. There is no documentation that allocation of resources results in improved quality. In Denmark we have recently focused on the quality of cancer treatment and have allocated resources without any evidence that it will improve survival, whereas less attention has been paid to less prestigious diseases. Length of stay can be an indicator of quality, as we operate with an efficient work process as a goal. But it is not a goal by itself, as only when coupled with cure or improvement in the disease can it be worth aiming at. We therefore compared the length of stay in Danish Departments of Internal Medicine to look for differences or similarities. MATERIAL AN METHODS: The homepage of the Danish National Board of Health, www.tal.dk (now terminated) was visited and data drawn for analyses. RESULTS: Six days seems to be the average length of stay in most departments, with some extreme deviations. A tendency towards a short stay in the department of Cardiology and a long term stay in the Geriatric Department was found as expected, but again extreme deviations were seen. DISCUSSION: No typical pattern was seen in the length of stay. A short stay is not attractive in itself, only when combined with a high quality of care and a healthy economy. Conversely, too short a stay can be risky if it is because of overcrowding and this must be prevented.
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