PubMed · 6908276
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1981-02-04. [Reform on a solid foundation is needed].. https://pubmed.ncbi.nlm.nih.gov/6908276/
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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.
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The aim of the study was to describe the bacteriology of bone allografts, which were harvested for the bone bank at Hvidovr Hospital, and to evaluate any infections in the recipients, which may have been caused by microbiological contamination of the transplanted bone allografts. It was carried out as a retrospective examination of bone bank records and patient records allowing at least 12 months for possible manifestation of bacterial infection by the bone allograft. During donation of bone, both the capita femora and the acetabulum were cultured with swabs both an- and aerobically along with the already sterilized glass specimen jar used for storage. Of the 110 donated bone allografts, 10 were not used for transplantation, but only one allograft was discarded because of the development of a positive culture (Staphylococcus epidermidis). All cultures from the sterilized glass specimen jars were without microbiological growth. Three incidences of deep infection (one Acinetobacter calcoaceticus and two Staphylococcus aureus) followed the transplantation of 100 bone allografts in 58 patients at 62 operations. We conclude that the precautions (i.e. careful selection and screening of donor) and strict aseptic technique (including the use of perioperative administration of antibiotics) used, when bone allografts are harvested, ensure the procurement of non-contaminated bone in more than 99% of the donations. Culturing the already sterilized glass specimen jars seems unnecessary. The bone allograft per se was not contaminated and probably did not cause any infections. The rate of infection after transplantation of bone allograft is not higher than in other complicated surgery.