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  • Vaccination of healthcare personnel in Europe: update to current policies
    Publication . Maltezou, Helena C.; Botelho-Nevers, Elisabeth; Brantsæter, Arne B.; Carlsson, Rose-Marie; Heininger, Ulrich; Hübschen, Judith M.; Josefsdottir, Kamilla S.; Kassianos, George; Kyncl, Jan; Ledda, Caterina; Medić, Snežana; Nitsch-Osuch, Aneta; de Lejarazu, Raul Ortiz; Theodoridou, Maria; Van Damme, Pierre; van Essen, Gerrit A.; Wicker, Sabine; Wiedermann, Ursula; Poland, Gregory A.; Bino, Silvia; Wiedermann, Ursula; Van Damme, Pierre; Filipova, Radosveta; Draženović, Vladimir; Koliou, Maria; Fabianova, Katerina; Kyncl, Jan; Heilmann Jensen, Lise; Filippova, Irina; Elonsalo, Ulpu; Botelho-Nevers, Elisabeth; Wicker, Sabine; Maltezou, Helena C.; Theodoridou, Maria; Molnár, Zsuzsanna; Sigridur Josefsdottir, Kamilla; Sisson, Lynda; Ledda, Caterina; Perevoscikovs, Jurijs; Savrasova, Larisa; Caplinskas, Saulius; Berthet, Françoise; Hübschen, Judith M; Borg, Michael; Cirstea, Olga; Essen, Gerrit A. van; Brantsæter, Arne B.; Nitsch-Osuch, Aneta; Graça, Silva; Falup-Pecurariu, Oana; Mikheeva, Irina; Medić, Snežana; Kollárová, Dagmar; Mrvic, Tatjana; de Lejarazu, Raúl Ortiz; Carlsson, Rose-Marie; Roth, Adam; Heininger, Ulrich; Chernyshova, Liudmyla; Lapiy, Fedir; Kassianos, George; Poland, Gregory A.; Vaccination Policies for HCP in Europe Study Group
    We investigated and compared current national vaccination policies for health-care personnel (HCP) in Europe with results from our previous survey. Data from 36 European countries were collected using the same methodology as in 2011. National policies for HCP immunization were in place in all countries. There were significant differences in terms of number of vaccinations, target HCP and healthcare settings, and implementation regulations (recommended or mandatory vaccinations). Vaccination policies against hepatitis B and seasonal influenza were present in 35 countries each. Policies for vaccination of HCP against measles, mumps, rubella and varicella existed in 28, 24, 25 and 19 countries, respectively; and against tetanus, diphtheria, pertussis and poliomyelitis in 21, 20, 19, and 18 countries, respectively. Recommendations for hepatitis A immunization existed in 17 countries, and against meningococcus B, meningococcus C, meningococcus A, C, W, Y, and tuberculosis in 10, 8, 17, and 7 countries, respectively. Mandatory vaccination policies were found in 13 countries and were a pre-requisite for employment in ten. Comparing the vaccination programs of the 30 European countries that participated in the 2011 survey, we found that more countries had national vaccination policies against measles, mumps, rubella, hepatitis A, diphtheria, tetanus, poliomyelitis, pertussis, meningococcus C and/or meningococcus A, C, W, Y; and more of these implemented mandatory vaccination policies for HCP. In conclusion, European countries now have more comprehensive national vaccination programs for HCP, however there are still gaps. Given the recent large outbreaks of vaccine-preventable diseases in Europe and the occupational risk for HCP, vaccination policies need to be expanded and strengthened in several European countries. Overall, vaccination policies for HCP in Europe should be periodically re-evaluated in order to provide optimal protection against vaccine-preventable diseases and infection control within healthcare facilities for HCP and patients.
    2019-12-10Journal article Restricted access Show more
  • The European gonococcal antimicrobial surveillance programme (Euro-GASP) appropriately reflects the antimicrobial resistance situation for Neisseria gonorrhoeae in the European Union/European Economic Area
    Publication . Cole, Michelle J; Quinten, Chantal; Jacobsson, Susanne; Day, Michaela; Amato-Gauci, Andrew J; Woodford, Neil; Spiteri, Gianfranco; Unemo, Magnus; The Euro-GASP network
    Background: European Gonococcal Antimicrobial Surveillance Programme (Euro-GASP) antimicrobial resistance (AMR) data are used to inform gonorrhoea treatment guidelines; therefore the data need to be robust and representative. We assessed the extent to which Euro-GASP reflects national measures of the AMR situation for Neisseria gonorrhoeae across the European Union/European Economic Area (EU/EEA). Methods: We compared data from Euro-GASP with published national gonococcal AMR data from 15 countries for azithromycin, cefixime and ciprofloxacin for the period 2009 to 2013 and performed Poisson regression to identify differences (p < 0.05) between the proportions of resistant isolates. The 2014 Euro-GASP AMR data for each country (n = 19) were weighted to account for differences in the distribution of patient characteristics between Euro-GASP and EU/EEA epidemiological gonorrhoea surveillance data. Data were compared to determine whether estimates of resistance levels differed with regards to the 5% threshold used to assess the clinical utility of first-line gonorrhoea treatments. We assessed the quality of decentralised testing by comparing AMR data for isolates tested both centrally and in the participating laboratories, and by evaluating external quality assessment (EQA) performance. Results: There was no significant difference for azithromycin, cefixime and ciprofloxacin resistance when Euro-GASP country data were compared with data from national reports. Weighting slightly altered the Euro-GASP AMR estimates (by between - 4.7 and 4.7% from the unweighted estimates). Weighting resulted in greater changes in estimates of resistance to azithromycin (from - 9.5 to 2.7%) and ciprofloxacin (from - 14.8 to 17.9%) in countries with low isolate numbers and low completeness of reporting (n = 3). Weighting caused AMR levels to fall below or above the 5% threshold for cefixime or azithromycin, respectively in only two countries. Susceptibility category data submitted from the decentralised Euro-GASP laboratories were concordant with the Euro-GASP data (> 90%). EQA performance was also good; < 5% of the minimum inhibitory concentration (MIC) results differed by > 4-fold from the modal MIC of the EQA isolate. Conclusions: The overall prevalence of AMR reported by Euro-GASP reflects closely the AMR situation for N. gonorrhoeae in the EU/EEA. Euro-GASP data can be used to provide robust AMR estimates to inform the European guideline for the management of gonorrhoea.
    2019-12-10Journal article Open access Show more