Percorrer por data de Publicação, começado por "2026-03-17"
A mostrar 1 - 2 de 2
Resultados por página
Opções de ordenação
- Vaccine effectiveness against medically attended, laboratory-confirmed influenza in the I-MOVE primary care network in Europe, VEBIS project, 2024/25Publication . Lucaccioni, Héloïse; Pozo, Francisco; Pérez-Gimeno, Gloria; Dürrwald, Ralf; Uras, Marina; Domegan, Lisa; Oroszi, Beatrix; Meijer, Adam; Trobajo-Sanmartín, Camino; Ujvari, Dorina; Rodrigues, Ana Paula; Mlinarić, Ivan; Lazar, Mihaela; Rivas Wagner, Eva; Erdwiens, Annika; Enouf, Vincent; McKenna, Adele; Túri, Gergő; de Lange, Marit; Martínez-Baz, Iván; Latorre-Margalef, Neus; Guiomar, Raquel; Kurečić Filipovic, Sanja; Dinu, Sorin; Mokoroa, Olatz; Tolksdorf, Kristin; Masse, Shirley; Bennett, Charlene; Kristóf, Katalin; Hooiveld, Mariette; Castilla, Jesús; Santos Almeida, João; Višekruna Vučina, Vesna; Popescu, Rodica; Bacci, Sabrina; Kaczmarek, Marlena; Kissling, EstherBackground: We conducted a multicenter test-negative study to estimate vaccine effectiveness (VE) against medically attended, laboratory-confirmed influenza in primary care, Europe, 2024/25. Research design and methods: Specimens were collected from patients with acute respiratory infection. All or a random sample of viruses were sequenced. VE was (1-odds ratio) × 100, adjusted for confounders. Results: We included 7275 cases and 17,516 controls (weeks 40-2024-18-2025). The overall VE was 46% (95% CI: 40-52), lowest in adults ≥65 years at 28% (95% CI: 12-42). VE against influenza A(H1N1)pdm09 was 30% (95% CI: 19-40); ranging 16-34% by age and vaccination target group. Most (88%) circulating clades were 5a.2a, distinct from the vaccine clade. VE was 28% (95% CI: 7-45) against 5a.2a (C.1.9), and 6% (95% CI: -62-45) against the vaccine-matched clade 5a.2a.1 (D). VE against influenza A(H3N2) was 38% (95% CI: 26-49); ranging 20-66% by age and target group. Circulating viruses belonged to the vaccine clade 2a.3a.1, with 88% subclade (J.2). VE against influenza B was 76% (95% CI: 69-81); ranging 70-80% by age and target group; all viruses belonged to the vaccine clade V1A.3a.2, with diverse subclades. Conclusions: Influenza vaccination protected approximately one in two vaccinated individuals against medically attended infection in primary care in Europe, 2024/25, varying by (sub)type and age.
- Genomic evolution and re-emergence of a multidrug-resistant Clostridioides difficile RT027 clone with reduced vancomycin susceptibility driving a prolonged hospital outbreakPublication . Isidro, Joana; Dionísio, Filipa; Alves, Frederico; Almeida, Soraia; Santos, Cláudia; Santos, Manuel Mota; Reis, Ernestina; Oliveira, Júlio R.; Gomes, João Paulo; Oleastro, MónicaFollowing an extended period of declining prevalence of the epidemic Clostridioides difficile ribotype 027 (RT027) in Portugal, a genetically distinct, multidrug-resistant (MDR) RT027 strain with reduced susceptibility to vancomycin has emerged, causing a 15-month outbreak. This investigation provides epidemiological and genomic evidence for renewed circulation and evolutionary adaptation of this high-risk lineage. A comprehensive outbreak investigation was conducted in a tertiary-care hospital in northern Portugal between 2023 and 2025. Epidemiological and clinical data, antimicrobial exposures, and infection-control measures were analysed. Whole-genome sequencing (WGS) was performed to characterize the outbreak clone. Sixty-six RT027 C. difficile infection (CDI) cases were confirmed, with incidence peaking at 5.46 cases per 10,000 patient-bed days in April 2024. WGS revealed an unusual accumulation of AMR determinants conferring a broad MDR phenotype. Notably, all isolates harboured the VanR T115A substitution, a rare mutation previously linked to reduced vancomycin susceptibility, raising concerns regarding evolving antimicrobial tolerance within RT027. The close relatedness to 2016-2018 USA isolates suggests a recent emergence of this clone. Transmission was facilitated by structural constraints, limited isolation capacity and shared sanitary facilities. This prolonged outbreak documents the re-emergence and genomic evolution of a hypervirulent RT027 lineage, characterized by a concerning expansion of antimicrobial resistance and decreased vancomycin susceptibility and a high recurrence rate (25%). These findings highlight the ongoing adaptive potential of C. difficile under antimicrobial pressure and underscore the need for strengthened surveillance, genomic monitoring, and infection-prevention strategies to mitigate re-establishment of epidemic RT027 strains in Europe and beyond.