Percorrer por autor "Carannante, Anna"
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- Europe-wide expansion and eradication of multidrug-resistant Neisseria gonorrhoeae lineages: a genomic surveillance studyPublication . Sánchez-Busó, Leonor; Cole, Michelle J.; Spiteri, Gianfranco; Day, Michaela; Jacobsson, Susanne; Golparian, Daniel; Sajedi, Noshin; Yeats, Corin A.; Abudahab, Khalil; Underwood, Anthony; Bluemel, Benjamin; Aanensen, David M.; Unemo, Magnus; Pleininger, Sonja; Indra, Alexander; De Baetselier, Irith; Vanden Berghe, Wim; Hunjak, Blaženka; Blažić, Tatjana Nemeth; Maikanti-Charalambous, Panayiota; Pieridou, Despo; Zákoucká, Hana; Žemličková, Helena; Hoffmann, Steen; Cowan, Susan; Schwartz, Lasse Jessen; Peetso, Rita; Epstein, Jevgenia; Viktorova, Jelena; Ndeikoundam, Ndeindo; Bercot, Beatrice; Bébéar, Cécile; Lot, Florence; Buder, Susanne; Jansen, Klaus; Miriagou, Vivi; Rigakos, Georgios; Raftopoulos, Vasilios; Balla, Eszter; Dudás, Mária; Ásmundsdóttir, Lena Rós; Sigmundsdóttir, Guðrún; Hauksdóttir, Guðrún Svanborg; Gudnason, Thorolfur; Colgan, Aoife; Crowley, Brendan; Saab, Sinéad; Stefanelli, Paola; Carannante, Anna; Parodi, Patrizia; Pakarna, Gatis; Nikiforova, Raina; Bormane, Antra; Dimina, Elina; Perrin, Monique; Abdelrahman, Tamir; Mossong, Joël; Schmit, Jean-Claude; Mühlschlegel, Friedrich; Barbara, Christopher; Mifsud, Francesca; Van Dam, Alje; Van Benthem, Birgit; Visser, Maartje; Linde, Ineke; Kløvstad, Hilde; Caugant, Dominique; Młynarczyk-Bonikowska, Beata; Azevedo, Jacinta; Borrego, Maria-José; Nascimento, Marina Lurdes Ramos; Pavlik, Peter; Klavs, Irena; Murnik, Andreja; Jeverica, Samo; Kustec, Tanja; Vázquez Moreno, Julio; Diaz, Asuncion; Abad, Raquel; Velicko, Inga; Unemo, Magnus; Fifer, Helen; Shepherd, Jill; Patterson, LynseyBackground: Genomic surveillance using quality-assured whole-genome sequencing (WGS) together with epidemiological and antimicrobial resistance (AMR) data is essential to characterise the circulating Neisseria gonorrhoeae lineages and their association to patient groups (defined by demographic and epidemiological factors). In 2013, the European gonococcal population was characterised genomically for the first time. We describe the European gonococcal population in 2018 and identify emerging or vanishing lineages associated with AMR and epidemiological characteristics of patients, to elucidate recent changes in AMR and gonorrhoea epidemiology in Europe. Methods: We did WGS on 2375 gonococcal isolates from 2018 (mainly Sept 1-Nov 30) in 26 EU and EEA countries. Molecular typing and AMR determinants were extracted from quality-checked genomic data. Association analyses identified links between genomic lineages, AMR, and epidemiological data. Findings: Azithromycin-resistant N gonorrhoeae (8·0% [191/2375] in 2018) is rising in Europe due to the introduction or emergence and subsequent expansion of a novel N gonorrhoeae multi-antigen sequence typing (NG-MAST) genogroup, G12302 (132 [5·6%] of 2375; N gonorrhoeae sequence typing for antimicrobial resistance [NG-STAR] clonal complex [CC]168/63), carrying a mosaic mtrR promoter and mtrD sequence and found in 24 countries in 2018. CC63 was associated with pharyngeal infections in men who have sex with men. Susceptibility to ceftriaxone and cefixime is increasing, as the resistance-associated lineage, NG-MAST G1407 (51 [2·1%] of 2375), is progressively vanishing since 2009-10. Interpretation: Enhanced gonococcal AMR surveillance is imperative worldwide. WGS, linked to epidemiological and AMR data, is essential to elucidate the dynamics in gonorrhoea epidemiology and gonococcal populations as well as to predict AMR. When feasible, WGS should supplement the national and international AMR surveillance programmes to elucidate AMR changes over time. In the EU and EEA, increasing low-level azithromycin resistance could threaten the recommended ceftriaxone-azithromycin dual therapy, and an evidence-based clinical azithromycin resistance breakpoint is needed. Nevertheless, increasing ceftriaxone susceptibility, declining cefixime resistance, and absence of known resistance mutations for new treatments (zoliflodacin, gepotidacin) are promising.
- Injury Insights at a Glance: Exploring EU and WHO Healthcare Data Through an Interactive DashboardPublication . Giustini, M.; Alessio, P.; Carannante, Anna; Nijman, S.; Valkenberg, H.; JORGE SILVA ALVES, TATIANA DANIELA; Fian, Tabea; Kjærgaard, Kristian; IDB-FDS Reference GroupIssue. The dashboard satisfies the need to access the European Injury Database (EU-IDB) in an intuitive and easy way to provide standardized cross-national data on injury causes and circumstances from hospital emergency departments (ED) in Europe. This unique surveillance system supports evidence-based injury prevention through two complementary approaches: the comprehensive Full Data Set (IDB-FDS), which captures detailed external circumstances, and the streamlined Minimum Data Set (IDB-MDS), which provides population-based indicators. Description of the problem. An interactive dashboard has been developed by the Austrian Road Safety Board (KfV, Vienna) on behalf of EuroSafe to facilitate the analysis and visualization of data from the EU-IDB, specifically focusing on the aggregated MDS cases. The application is publicly accessible at https://wemospatrick-kfv-dashboard-main-bj1eya.streamlit.app/ site. The tool enables dynamic querying of the data, supporting the identification of patterns, temporal trends, and distributions by injury type, age group, sex, place of occurrence, and other relevant factors . Results. This dashboard provides injury and mortality rates per 100,000 inhabitants per year and the European Core Health Indicators (ECHI), both at the level of individual countries and for the EU27 as a whole. Additionally, it integrates injury-related mortality data from the WHO Mortality Database, enabling comparative analysis between fatal and non-fatal outcomes. Lessons. By combining these sources into a single interactive interface, the dashboard serves as a powerful resource for epidemiological surveillance, prevention planning, and evidence-based decision making. The system’s dual-tier methodology effectively balances detailed qualitative analysis with broader epidemiological monitoring, making it a valuable tool for policymakers, researchers, and safety promotion organizations involved in the development and evaluation of injury prevention strategies.
- Significant increase in azithromycin “resistance” and susceptibility to ceftriaxone and cefixime in Neisseria gonorrhoeae isolates in 26 European countries, 2019Publication . Day, Michaela J.; Jacobsson, Susanne; Spiteri, Gianfranco; Kulishev, Carina; Sajedi, Noshin; Woodford, Neil; Blumel, Benjamin; van der Werf, Marieke J.; Amato-Gauci, Andrew J.; Unemo, Magnus; Cole, Michelle J.; Eder, Claudia; Pleininger, Sonja; Huhlescu, Steliana; de Baetselier, Irith; Hunjak, Blaženka; Blažić, Tatjana Nemeth; Maikanti-Charalampous, Panagiota; Pieridou, Despo; Zákoucká, Hana; Žemličková, Helena; Hoffmann, Steen; Cowan, Susan; Peetso, Rita; Viktorova, Jelena; Ndeikoundam, Ndeindo; Bercot, Beatrice; Sampo, Anu Patari; Kirjavainen, Vesa; Buder, Susanne; Jansen, Klaus; Miriagou, Vivi; Balla, Eszter; Dudás, Mária; Sigmundsdóttir, Guðrún; Asmundsdottir, Lena Ros; Saab, Sinead; Crowley, Brendan; Carannante, Anna; Stefanelli, Paola; Pakarna, Gatis; Mavcutko, Violeta; Cassar, Robert; Barbara, Christopher; Vella, Francesca; Van Dam, Alje; Linde, Ineke; Caugant, Dominique; Kløvstad, Hilde; Mlynarczyk-Bonikowska, Beata; Borrego, Maria-José; Pavlik, Peter; Klavs, Irena; Kustec, Tanja; Vazquez, Julio; Diaz, Asuncion; Torreblanca, Raquel Abad; Velicko, Inga; Unemo, Magnus; Fifer, Helen; Templeton, KateBackground: The European Gonococcal Antimicrobial Surveillance Programme (Euro-GASP) performs annual sentinel surveillance of Neisseria gonorrhoeae susceptibility to therapeutically relevant antimicrobials across the European Union/European Economic Area (EU/EEA). We present the Euro-GASP results from 2019 (26 countries), linked to patient epidemiological data, and compared with data from previous years. Methods: Agar dilution and minimum inhibitory concentration (MIC) gradient strip methodologies were used to determine the antimicrobial susceptibility (using EUCAST clinical breakpoints, where available) of 3239 N. gonorrhoeae isolates from 26 countries across the EU/EEA. Significance of differences compared with Euro-GASP results in previous years was analysed using Z-test and the Pearson's χ2 test was used to assess significance of odds ratios for associations between patient epidemiological data and antimicrobial resistance. Results: European N. gonorrhoeae isolates collected between 2016 and 2019 displayed shifting MIC distributions for; ceftriaxone, with highly susceptible isolates increasing over time and occasional resistant isolates each year; cefixime, with highly-susceptible isolates becoming increasingly common; azithromycin, with a shift away from lower MICs towards higher MICs above the EUCAST epidemiological cut-off (ECOFF); and ciprofloxacin which is displaying a similar shift in MICs as observed for azithromycin. In 2019, two isolates displayed ceftriaxone resistance, but both isolates had MICs below the azithromycin ECOFF. Cefixime resistance (0.8%) was associated with patient sex, with resistance higher in females compared with male heterosexuals and men-who-have-sex-with-men (MSM). The number of countries reporting isolates with azithromycin MICs above the ECOFF increased from 76.9% (20/26) in 2016 to 92.3% (24/26) in 2019. Isolates with azithromycin MICs above the ECOFF (9.0%) were associated with pharyngeal infection sites. Following multivariable analysis, ciprofloxacin resistance remained associated with isolates from MSM and heterosexual males compared with females, the absence of a concurrent chlamydial infection, pharyngeal infection sites and patients ≥ 25 years of age. Conclusions: Resistance to ceftriaxone and cefixime remained uncommon in EU/EEA countries in 2019 with a significant decrease in cefixime resistance observed between 2016 and 2019. The significant increase in azithromycin "resistance" (azithromycin MICs above the ECOFF) threatens the effectiveness of the dual therapy (ceftriaxone + azithromycin), i.e., for ceftriaxone-resistant cases, currently recommended in many countries internationally and requires close monitoring.
- Ten years of external quality assessment (EQA) of Neisseria gonorrhoeae antimicrobial susceptibility testing in Europe elucidate high reliability of dataPublication . Cole, Michelle J.; Quaye, Nerteley; Jacobsson, Susanne; Day, Michaela; Fagan, Elizabeth; Ison, Catherine; Pitt, Rachel; Seaton, Shila; Woodford, Neil; Stary, Angelika; Pleininger, Sonja; Crucitti, Tania; Hunjak, Blaženka; Maikanti, Panayiota; Hoffmann, Steen; Viktorova, Jelena; Buder, Susanne; Kohl, Peter; Tzelepi, Eva; Siatravani, Eirini; Balla, Eszter; Hauksdóttir, Guðrún Svanborg; Rose, Lisa; Stefanelli, Paola; Carannante, Anna; Pakarna, Gatis; Mifsud, Francesca; Cassar, Rosann Zammit; Linde, Ineke; Bergheim, Thea; Steinbakk, Martin; Mlynarczyk-Bonikowska, Beata; Borrego, Maria-José; Shepherd, Jill; Pavlik, Peter; Jeverica, Samo; Vazquez, Julio; Abad, Raquel; Weiss, Sabrina; Spiteri, Gianfranco; Unemo, MagnusBackground: Confidence in any diagnostic and antimicrobial susceptibility testing data is provided by appropriate and regular quality assurance (QA) procedures. In Europe, the European Gonococcal Antimicrobial Susceptibility Programme (Euro-GASP) has been monitoring the antimicrobial susceptibility in Neisseria gonorrhoeae since 2004. Euro-GASP includes an external quality assessment (EQA) scheme as an essential component for a quality-assured laboratory-based surveillance programme. Participation in the EQA scheme enables any problems with the performed antimicrobial susceptibility testing to be identified and addressed, feeds into the curricula of laboratory training organised by the Euro-GASP network, and assesses the capacity of individual laboratories to detect emerging new, rare and increasing antimicrobial resistance phenotypes. Participant performance in the Euro-GASP EQA scheme over a 10 year period (2007 to 2016, no EQA in 2013) was evaluated. Methods: Antimicrobial susceptibility category and MIC results from the first 5 years (2007-2011) of the Euro-GASP EQA were compared with the latter 5 years (2012-2016). These time periods were selected to assess the impact of the 2012 European Union case definitions for the reporting of antimicrobial susceptibility. Results: Antimicrobial susceptibility category agreement in each year was ≥91%. Discrepancies in susceptibility categories were generally because the MICs for EQA panel isolates were on or very close to the susceptibility or resistance breakpoints. A high proportion of isolates tested over the 10 years were within one (≥90%) or two (≥97%) MIC log2 dilutions of the modal MIC, respectively. The most common method used was Etest on GC agar base. There was a shift to using breakpoints published by the European Committee on Antimicrobial Susceptibility Testing (EUCAST) in the latter 5 years, however overall impact on the validity of results was limited, as the percentage categorical agreement and MIC concordance changed very little between the two five-year periods. Conclusions: The high level of comparability of results in this EQA scheme indicates that high quality data are produced by the Euro-GASP participants and gives confidence in susceptibility and resistance data generated by laboratories performing decentralised testing.
- Understanding occupational injuries among non-residents in Europe: evidence from the EU-IDBPublication . Giustini, Marco; JORGE SILVA ALVES, TATIANA DANIELA; Carannante, Anna; Papadakaki, MariaBackground: Occupational injuries (OI) -resulting from exposure to various workplace hazards- among non-resident populations are a significant but underexplored public health issue and are poorly captured in national injury surveillance systems. Methods: We analyzed emergency department (ED) OI data from the European Injury Database (EU-IDB), during 2018-2022, identifying non-resident cases through the “Country of Permanent Residence” field. OI were defined as unintentional injuries sustained during paid work activities. Results: From the EU-IDB databank, 315,063 ED cases of OI (mean age 37.9 years; SD±13.2) were identified (77.5% involving males). Of all cases, 17,501 (5.6%) involved non-residents in the country where treatment was received. The proportion of OI among non-residents was higher in males than females (6.0% vs. 4.4%), with comparable mean age (37.4 vs. 37.5 years, p=0.64). Hospitalization occurred in 9.3% of non-resident cases, with a higher rate in males (10.1% vs 5.1%). The mean length of stay was 7.1 days, with no significant sex-based difference (M: 7.1; F: 7.4, p=0.76). Injury patterns varied by sex: the most frequent OI in males were open wounds (31.9%), contusions (24.2%), and fractures (14.9%), while females most sustained contusions (31.0%), open wounds (19.3%), and distortions (15.3%). Hands and fingers were the most affected body parts in both sexes (M: 30.7%; F: 25.7%). Males also frequently injured the eye area (7.6%), while females more often injured the ankle (9.7%). Occupational sector patterns showed that 47.5% of injuries among non-resident males occurred in construction, while for non-resident female 29.0% in health care, trade and education sectors. Conclusions: The IDB-FDS offers valuable insight into occupational risks faced by non-residents. Gender and sector-specific injury trends highlight the need for improved surveillance systems that include migration and employment data to better inform targeted prevention efforts.