PubMed · 14346339
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O WEBER. 1965-04-01. [DANISH PRACTITIONERS].. https://pubmed.ncbi.nlm.nih.gov/14346339/
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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.
BACKGROUND: Planned inguinal herniorrhaphy may present a clinical dilemma when no hernia is found. No large-scale data are available on the incidence of this problem, and, therefore, no recommendations exist for choice of surgical intervention. MATERIAL AND METHODS: Data were extracted from the Danish Hernia Database covering the interval from 1 January 1998-5 April 2002, and included 42,356 groin hernia repairs. Results. No hernia was found in 313 cases (0.74%). These patients were divided into three groups (lipomas, no pathology, and a "weak abdominal wall") and analysed according to surgical technique. There were 11 reoperations (3.5%) of which three were femoral and eight inguinal hernias, without differences between type of initial operation (herniorrhaphy or no herniorrhaphy). CONCLUSION: This study of 42,356 groin hernia repairs showed that in 313 patients (0.74%), no hernia was found. Recurrences did not occur with higher frequency in patients receiving no repair. Based on these data and the risk of chronic postherniorrhaphy pain, we suggest that no repair be performed when no inguinal hernia is found during planned inguinal herniorrhaphy.
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