PubMed · 7324250
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O M Jensen, J Mosbach. 1981-10-26. [Technological evaluation and screening].. https://pubmed.ncbi.nlm.nih.gov/7324250/
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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.
In a modern health care system continuing measurement and monitoring of relevant clinical data comprise the base of documentation for the quality of care. Internationally there has been increasing focus on monitoring and measuring the quality of care using principals from clinical epidemiology, including quality monitoring using clinical indicators. Indicators can be derived with regard to structure, process and outcome. The indicators should be in a form which can be used within the individual department and for comparison between hospitals nationally and internationally. The idea of professional indicators is to be able to track developments over time, as well to be able to respond at relevant times. The work with quality indicators will support continuing work with quality development in the medical specialities as well as giving a possibility for dialogue between politicians, the management system and the medical specialities about priority of resources and the structure of the hospital system, which extend further than the simpler issues of finance, which have been dominating until now.
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