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Point prevalence surveys of healthcare-associated infections (HAI) and antimicrobial use in the European Union and European Economic Area (EU/EEA) from 2016 to 2017 included 310,755 patients from 1,209 acute care hospitals (ACH) in 28 countries and 117,138 residents from 2,221 long-term care facilities (LTCF) in 23 countries. After national validation, we estimated that 6.5% (cumulative 95% confidence interval (cCI): 5.4-7.8%) patients in ACH and 3.9% (95% cCI: 2.4-6.0%) residents in LTCF had at least one HAI (country-weighted prevalence). On any given day, 98,166 patients (95% cCI: 81,022-117,484) in ACH and 129,940 (95% cCI: 79,570-197,625) residents in LTCF had an HAI. HAI episodes per year were estimated at 8.9 million (95% cCI: 4.6-15.6 million), including 4.5 million (95% cCI: 2.6-7.6 million) in ACH and 4.4 million (95% cCI: 2.0-8.0 million) in LTCF; 3.8 million (95% cCI: 3.1-4.5 million) patients acquired an HAI each year in ACH. Antimicrobial resistance (AMR) to selected AMR markers was 31.6% in ACH and 28.0% in LTCF. Our study confirmed a high annual number of HAI in healthcare facilities in the EU/EEA and indicated that AMR in HAI in LTCF may have reached the same level as in ACH.

Point prevalence surveys of healthcare-associated infections (HAI) and antimicrobial use in the European Union and European Economic Area (EU/EEA) from 2016 to 2017 included 310,755 patients from 1,209 acute care hospitals (ACH) in 28 countries and 117,138 residents from 2,221 long-term care facilities (LTCF) in 23 countries. After national validation, we estimated that 6.5% (cumulative 95% confidence interval (cCI): 5.4-7.8%) patients in ACH and 3.9% (95% cCI: 2.4-6.0%) residents in LTCF had at least one HAI (country-weighted prevalence). On any given day, 98,166 patients (95% cCI: 81,022-117,484) in ACH and 129,940 (95% cCI: 79,570-197,625) residents in LTCF had an HAI. HAI episodes per year were estimated at 8.9 million (95% cCI: 4.6-15.6 million), including 4.5 million (95% cCI: 2.6-7.6 million) in ACH and 4.4 million (95% cCI: 2.0-8.0 million) in LTCF; 3.8 million (95% cCI: 3.1-4.5 million) patients acquired an HAI each year in ACH. Antimicrobial resistance (AMR) to selected AMR markers was 31.6% in ACH and 28.0% in LTCF. Our study confirmed a high annual number of HAI in healthcare facilities in the EU/EEA and indicated that AMR in HAI in LTCF may have reached the same level as in ACH. ispartof: EUROSURVEILLANCE vol:23 issue:46 pages:41-+ ispartof: location:Sweden status: published

Avian metapneumoviruses (AMPV) of subtype B dominate over other subtypes on Italian poultry farms in northern Italy. AMPVs from the Veneto region of Italy between 1987 and 2007 were sequenced in their attachment (G) and fusion (F) protein genes, together with other subtype B AMPVs from other parts of Western Europe, collected prior to 1994. All viruses in the survey had very similar predicted F sequences whereas the predicted G protein sequences found in Italy from 2001 were distinctly different from those found in pre 1994 viruses. Nonetheless pre 1994 Italian AMPVs were more similar to post 2000 AMPVs than other pre 1994 viruses from other parts of Europe, thereby showing that the later viruses had probably evolved from early Italian viruses. The occurrence of the later variants followed introduction of the mass administration with a single subtype B vaccine and its G protein sequence placed it clearly in the pre 1994 cluster. The possibility of the vaccine having driven field virus evolution in order to evade immune pressure cannot be excluded.

La Malattia di Newcastle (ND), sostenuta dai ceppi patogeni di Paramyxovirus 1, è ritenuta una delle più temibili forme infettive dei volatili per la sua gravità e trasmissibilità; in specie quali il pollo può causare mortalità fino al 100%. Assieme alle norme di profilassi diretta, la vaccinazione è punto cardine del controllo della malattia. L’infezione da Metapneumovirus aviare (AMPV) causa la Rinotracheite infettiva del tacchino ed è fra le cause, assieme ad Escherichia coli, della Sindrome della testa gonfia nel pollo. Per la profilassi di quest’infezione, ampiamente diffusa nel nostro Paese, la vaccinazione è strumento imprescindibile che, anche nel pollo, sta assumendo grande rilevanza. Poiché, per entrambi i virus, la vaccinazione viene consigliata nelle prime settimane di vita mediante vaccino vivo, di particolare interesse pratico risulta poter associare questi interventi. In tale evenienza risultano necessarie informazioni sulla compatibilità fra i virus vaccinali. Infatti, quando si associano vaccini vivi diversi è fondamentale assicurarsi che non vi siano interferenze negative fra essi, tali da compromettere l’efficacia delle vaccinazioni o addirittura causare effetti patologici indesiderati. L’obiettivo del presente lavoro è stato appunto quello di valutare l'interferenza fra ceppi vaccinali di NDV e AMPV somministrati in polli Specific Pathogen Free (SPF) singolarmente o in associazione. La ricerca è stata svolta mediante prove sperimentali condotte in condizioni di isolamento biologico e sono stati usati come indicatori la persistenza dei virus vaccinali nell'ospite, la risposta immunitaria e la protezione dalla forma clinica e dalla replicazione virale dopo infezione di prova.

Dati epidemiologici sulla prevalenza di AMPV in allevamenti di tacchini da carne del Nord Italia hanno messo in evidenza come, dopo l’introduzione della vaccinazione di massa, il numero di positività per AMPV sia complessivamente diminuito negli anni in concomitanza con un aumento del numero di positività osservate in età avanzata (43-90 giorni di età), in gruppi vaccinati col medesimo sottotipo. Il successivo sequenziamento completo del gene di adesione (G) di alcuni isolati responsabili di focolai tardivi in gruppi vaccinati, ha permesso di distinguerli nettamente dal ceppo vaccinale e da tutti i ceppi di AMPV italiani isolati prima del 2001. Allo scopo di determinare se le mutazioni osservate nei ceppi “più recenti” siano state sufficienti al virus per eludere l’immunità vaccinale è stata eseguita un’infezione sperimentale in tacchini vaccinati, inoculandoli con un ceppo isolato nel 2004 o con un ceppo del 1987, e valutando la protezione mediante misurazione della sintomatologia clinica e dell’eliminazione virale.

Allo scopo di delineare un quadro della situazione di campo il più possibile aderente alla realtà, e sulla base di questo sviluppare adeguati piani profilattici, è stata svolta sul territorio nazionale, in particolare nelle aree a rischio d’infezione, un’indagine sulla diffusione di AMPV nell’allevamento della gallina ovaiola. Il progetto ha previsto studi longitudinali e campionamenti singoli in allevamenti sia in fase pollastra che ovaiola, per la ricerca di AMPV diretta, mediante RT-PCR, ed indiretta mediante test ELISA. Dove possibile i risultati sono stati integrati con i dati produttivi dell’allevamento, gli eventuali piani vaccinali applicati e cali dell’ovo deposizione.

I vaccini vivi attenuati conferiscono una buona protezione ma la loro instabilità può portarli a riacquisire virulenza anche dopo un limitato numero di retropassaggi. Sperimentalmente è stato dimostrato che sono sufficienti 4-10 retropassaggi su animali sensibili. Uno studio successivo ha dimostrato come ciò può avvenire anche in allevamento. Animali vaccinati al primo giorno di vita in incubatoio con un sottotipo A hanno mostrato, dopo 3 settimane, una forma respiratoria durante la quale è stato isolato un AMPV sottotipo A. Il sequenziamento dell'intero genoma virale e l'identificazione di 9 nucleotidi marker vaccinali ne ha dimostrato l'inequivocabile origine vaccinale. In questo lavoro viene riportato un focolaio di TRT verificatosi in Italia nel 2003, dovuto ad AMPV sottotipo A di origine vaccinale che ha interessato tacchini di 7 settimane vaccinati con un sottotipo B.

A virus was isolated in association with respiratory disease typical of turkey rhinotracheitis, from turkeys which had been vaccinated with a B subtype licensed Avian Metapneumovirus vaccine. Sequencing of the virus showed that, as in a previous similar report, the virus had originated from a licensed live A subtype vaccine. In this instance the disease was much later, at 50 days of age, and there had been no recent history of use of the vaccine. This may indicate that AMPV vaccines are able to circulate in the environment for longer than was previously envisaged.

Longitudinal studies in Italian turkey farms demonstrated that subtype B virus was frequently detected some period after subtype B vaccination. Sequencing showed that these later viruses were not derived form the previously applied vaccine. More detailed sequence analysis of fusion and attachment protein genes showed that these later subtype B detections formed a cluster. The attachment protein genes in this cluster were dissimilar to all those found in early B subtype viruses, including the established vaccines, and these themselves formed another cluster. One day old poults were vaccinated with subtype B vaccine in experimental conditions and later challenged with either early (240 TRT-VR87) or later (205-16/04) subtype B field isolates. Protection was very poor as assessed by both clinical disease and shedding of virus after 205-16/04 challenge. The limited immunity observed may explain the dominance of the later type subtype B field viruses over a six year period in this Italian region. This may have resulted from immune pressure induced by mass subtype B vaccination.

Precedenti esperienze di campo hanno evidenziato come estratti naturali di legno di castagno, contribuiscano al controllo delle forme enteriche nel pollo ed in altre specie avicole allevate intensivamente. Tali sostanze contengono tannini idrolizzabili di origine vegetale. Il presente lavoro riporta uno studio preliminare sull’attività antivirale in vitro di un estratto naturale di legno di Castagno (Castanea spp.) denominato Silvafeed ENC 400®. L’estratto è stato testato in vitro nei riguardi di Reovirus (ARV) e Metapneumovirus (AMPV) aviari. Silvafeed ENC 400® ha mostrato proprietà antivirali extracellulari sia nei confronti di ARV (IC50=54 µg/ml) che di AMPV (IC50=58 µg/ml). Il composto preso in esame ha mostrato scarsa tossicità per il substrato cellulare utilizzato nelle prove (CC50=243,04 µg/ml), ciò ha permesso di procedere con i test di attività antivirale partendo anche da concentrazioni elevate. Tali risultati sono incoraggianti e suggeriscono un possibile utilizzo di Silvafeed ENC 400® nel controllo delle infezioni virali aviari. Prove in vivo saranno necessarie per confermare tale ipotesi

Avian Pneumovirus infection in Italy is reported from its first appearance in 1987 to present day. The B type virus has been found in different geographical regions but more recently, A type virus has also been detected. To establish the identity and heterogeneity among the APV strains that circulated in Italy from 1987 to 2004, the nucleotide sequences of whole Fusion protein gene were determined and compared with European APV field strains and commonly available vaccine strains.

Newcastle disease (ND), together with highly pathogenic avian influenza, is one of the most devastating diseases of poultry and other birds and vaccination is one method of control.. Susceptibility to Newcastle disease virus (NDV) of both free-living and reared pheasants is well known and was confirmed during the epidemic of ND that affected Italy during 2000. On that occasion the advisability of releasing ND vaccinated, semi-intensive reared pheasants into the wild was questioned. There was the possibility that vaccinated pheasants might develop an infection with a velogenic NDV which would then spread.. In this paper an experimental infection of eight pheasants vaccinated with live and killed NDV vaccines, is reported. The birds were infected by the oronasal route with a velogenic strain of NDV which was isolated in 2000 from a wild pheasant. Birds were observed daily for clinical signs and mortality throughout the experiment. Tracheal and cloacal swabs were collected for virus isolation on tracheal organ cultures.and recovery was confirmed by RT nested PCR using extracted RNA. Blood samples were collected and tested for NDV antibodies by hemagglutination-inhibition assay. Severe nervous signs were observed in one bird 6 days post infection. NDV was isolated from the trachea of 5 pheasants from day 2 up to day 5 post infection. It was never recovered from the cloaca. Seroconversion was observed in all the birds. It was shown that that vaccinated pheasants can become infected with a velogenic NDV and shed it by the respiratory route, though not themselves show any disease. Therefore they pose a potential threat to wild and domestic birds with which they will come into contact. This experiment highlights important health implications which may arise from administration of avifauna and which should be given due consideration.

Antimicrobials are commonly prescribed and contribute to the development of antimicrobial resistance in long-term care facilities (LTCFs). In 2010, the European Centre for Disease Prevention and Control initiated point prevalence surveys (PPS) of healthcare-associated infections and antimicrobial use in European LTCFs, performed by external contractors as the Healthcare-Associated infections in Long-Term care facilities (HALT) projects. Here, we investigated prevalence and characteristics of antimicrobial use and antimicrobial stewardship indicators in European LTCFs in 2016-17. Twenty-four European Union/European Economic Area (EU/EEA) countries, the former Yugoslav Republic of Macedonia and Serbia participated in the third PPS in European LTCFs. Overall, 4.9% (95% confidence interval: 4.8-5.1) of LTCF residents in the EU/EEA participating countries received at least one antimicrobial. The most commonly reported Anatomical Therapeutic Chemical (ATC) groups were beta-lactam antibacterials/penicillins (J01C), other antibacterials (J01X) (e.g. glycopeptide antibacterials, polymyxins), quinolones (J01M), sulfonamides and trimethoprim (J01E), and other beta-lactams (J01D). Urinary tract infections and respiratory tract infections were the main indications for antimicrobial prescription. This PPS provides updated and detailed information on antimicrobial use in LTCFs across the EU/EEA that can be used to identify targets for future interventions, follow-up of these interventions and promote prudent use of antimicrobials in European LTCFs. ispartof: EUROSURVEILLANCE vol:23 issue:46 pages:29-40 ispartof: location:Sweden status: published