Herman Goossens

University of Nottingham, Nottigham, England, United Kingdom

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Publications (494)2602.68 Total impact

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    ABSTRACT: Transplantation of neural stem cells (NSC) in diseased or injured brain tissue is widely studied as a potential treatment for various neurological pathologies. However, effective cell replacement therapy relies on the intrinsic capacity of cellular grafts to overcome hypoxic and/or immunological barriers after transplantation. In this context, it is hypothesized that structural support for grafted NSC will be of utmost importance. With this study, we present a novel decellularization protocol for 1.5 mm thick mouse brain sections, resulting in the generation of acellular three-dimensional (3D) brain sections. Next, the obtained 3D brain sections were seeded with murine NSC expressing both the eGFP and luciferase reporter proteins (NSC-eGFP/Luc). Using real-time bioluminescence imaging, the survival and growth of seeded NSC-eGFP/Luc cells was longitudinally monitored for 1-7 weeks in culture, indicating the ability of the acellular brain sections to support sustained ex vivo growth of NSC. Next, the organization of a 3D maze-like cellular structure was examined using confocal microscopy. Moreover, under mitogenic stimuli (EGF and hFGF-2), most cells in this 3D culture retained their NSC phenotype. Concluding, we here present a novel protocol for decellularization of mouse brain sections, which subsequently support long-term 3D culture of undifferentiated NSC. Copyright © 2014 Elsevier Ltd. All rights reserved.
    Biomaterials 02/2015; 41C:122-131. · 8.31 Impact Factor
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    ABSTRACT: Currently, virus discovery is mainly based on molecular techniques. Here, we propose a method that relies on virus culturing combined with state-of-the-art sequencing techniques. The most natural ex vivo culture system was used to enable replication of respiratory viruses. Three respiratory clinical samples were tested on well-differentiated pseudostratified tracheobronchial human airway epithelial (HAE) cultures grown at an air-liquid interface, which resemble the airway epithelium. Cells were stained with convalescent serum of the patients to identify infected cells and apical washes were analyzed by VIDISCA-454, a next-generation sequencing virus discovery technique. Infected cells were observed for all three samples. Sequencing subsequently indicated that the cells were infected by either human coronavirus OC43, influenzavirus B, or influenzavirus A. The sequence reads covered a large part of the genome (52%, 82%, and 57%, respectively). We present here a new method for virus discovery that requires a virus culture on primary cells and an antibody detection. The virus in the harvest can be used to characterize the viral genome sequence and cell tropism, but also provides progeny virus to initiate experiments to fulfill the Koch's postulates. © 2014 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.
    Influenza and Other Respiratory Viruses 12/2014; · 1.47 Impact Factor
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    ABSTRACT: Lower respiratory tract infection (LRTI) is a common presentation in primary care, but little is known about associated patients' illness perception and related behaviour. To describe illness perceptions and related behaviour in patients with LRTI visiting their general practitioner (GP) and identify differences between European regions and types of health care system. Adult patients presenting with acute cough were included. GPs recorded co morbidities and clinical findings. Patients filled out a diary for up to 4 weeks on their symptoms, illness perception and related behaviour. The chi-square test was used to compare proportions between groups and the Mann-Whitney U or Kruskal Wallis tests were used to compare means. Three thousand one hundred six patients from 12 European countries were included. Eighty-one per cent (n = 2530) of the patients completed the diary. Patients were feeling unwell for a mean of 9 (SD 8) days prior to consulting. More than half experienced impairment of normal or social activities for at least 1 week and were absent from work/school for a mean of 4 (SD 5) days. On average patients felt recovered 2 weeks after visiting their GP, but 21% (n = 539) of the patients did not feel recovered after 4 weeks. Twenty-seven per cent (n = 691) reported feeling anxious or depressed, and 28% (n = 702) re-consulted their GP at some point during the illness episode. Reported illness duration and days absent from work/school differed between countries and regions (North-West versus South-East), but there was little difference in reported illness course and related behaviour between health care systems (direct access versus gate-keeping). Illness course, perception and related behaviour in LRTI differ considerably between countries. These finding should be taken into account when developing International guidelines for LRTI and interventions for setting realistic expectations about illness course. © The Author 2014. Published by Oxford University Press.
    Family practice. 11/2014;
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    ABSTRACT: Appropriate use of systemic antifungals is vital in the prevention and treatment of invasive fungal infection (IFI) in immunosuppressed children and neonates. This multi-centre observational study describes the inpatient prescribing practice of antifungal drugs in children and neonates, and identifies factors associated with prescribing variability. A single day point prevalence study of antimicrobial use in hospitalised neonates and children was performed between October and December 2012. Data were entered through a study-specific web-based portal using a standardised data-entry protocol. Data were recorded from 17,693 patients within 226 centres. A total of 136 centres recorded data from 1092 children and 380 neonates receiving at least one antifungal agent. The most frequently prescribed systemic antifungals were fluconazole (n=355) and amphotericin B deoxycholate (n=195). The most common indications for antifungal administration in children were medical prophylaxis (n=325), empiric treatment of febrile neutropenia (n=122) and treatment of confirmed or suspected IFI (n=100, 14%). Treatment of suspected IFI in low birth weight neonates accounted for the majority of prescriptions in neonatal units (n=103). ANOVA analysis demonstrated no significant effect of clinical indication (prophylaxis or treatment of systemic or localised infection) on total daily dose (TDD). Fewer than half of patients (n=371) received a TDD within the dosing range recommended in current guidelines. Sub-therapeutic doses were prescribed in 416 cases (47%). The predominance of fluconazole and high incidence of sub-therapeutic doses in participating hospitals may contribute to suboptimal clinical outcomes and an increased predominance in resistant pathogenic fungi. A global consensus on antifungal dosing and coordinated stewardship programmes are needed to promote consistent and appropriate use of antifungal drugs in neonates and children. Copyright © 2014, American Society for Microbiology. All Rights Reserved.
    Antimicrobial Agents and Chemotherapy 11/2014; · 4.57 Impact Factor
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    ABSTRACT: Evidence shows a high rate of unnecessary antibiotic prescriptions in primary care in Europe and the United States. Given the costs of widespread use and associated antibiotic resistance, reducing inappropriate use is a public health priority.
    Journal of general internal medicine. 11/2014;
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    ABSTRACT: Background Whole genome (optical) mapping (WGM), a state-of-the-art mapping technology based on the generation of high resolution restriction maps, has so far been used for typing clinical outbreak strains and for mapping de novo sequence contigs in genome sequencing projects. We employed WGM to assess the genomic stability of previously sequenced Staphylococcus aureus strains that are commonly used in laboratories as reference standards. Results S. aureus strains (n = 12) were mapped on the ArgusTM Optical Mapping System (Opgen Inc, Gaithersburg, USA). Assembly of NcoI-restricted DNA molecules, visualization, and editing of whole genome maps was performed employing MapManager and MapSolver softwares (Opgen Inc). In silico whole genome NcoI-restricted maps were also generated from available sequence data, and compared to the laboratory-generated maps. Strains showing differences between the two maps were resequenced using Nextera XT DNA Sample Preparation Kit and Miseq Reagent Kit V2 (MiSeq, Illumina) and de novo assembled into sequence contigs using the Velvet assembly tool. Sequence data were correlated with corresponding whole genome maps to perform contig mapping and genome assembly using MapSolver. Of the twelve strains tested, one (USA300_FPR3757) showed a 19-kbp deletion on WGM compared to its in silico generated map and reference sequence data. Resequencing of the USA300_FPR3757 identified the deleted fragment to be a 13kbp-long integrative conjugative element ICE6013. Conclusions Frequent subculturing and inter-laboratory transfers can induce genomic and therefore, phenotypic changes that could compromise the utility of standard reference strains. WGM can thus be used as a rapid genome screening method to identify genomic rearrangements whose size and type can be confirmed by sequencing.
    BMC Research Notes 10/2014; 7(704).
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    ABSTRACT: Nitrofurantoin has been used for decades for the treatment of urinary tract infections (UTI), however, clinically significant resistance in E. coli is as yet uncommon. Nitrofurantoin concentrations in the gastrointestinal tract tend to be low, which might facilitate selection of nitrofurantoin-resistant (NIT-R) strains in the gut flora. We subjected two nitrofurantoin-susceptible intestinal E. coli strains (ST540-p, ST2747-p) to increasing nitrofurantoin concentrations under aerobic and anaerobic conditions. Whole genome sequencing was performed on both susceptible isolates and on selected mutants that exhibited the highest nitrofurantoin resistance levels aerobically (ST540-a, ST2747-a) and anaerobically (ST540-an, ST2747-an). ST540-a/-an and ST2747-a (aerobic MIC >64 μg/ml) harbored mutations in known nitrofurantoin resistance determinants, nfsA and/or nfsB that encode oxygen-insensitive nitroreductases. ST2747-an showed reduced nitrofurantoin susceptibility (aerobic MIC 32 μg/ml) and exhibited remarkable growth deficits, however, did not harbor nfsA/B mutations. We identified a 12-nucleotide deletion in ribE encoding lumazine synthase, an essential enzyme involved in the biosynthesis of FMN, an important cofactor of NfsA/B. Complementing ST2747-an with a functional wild-type lumazine synthase restored nitrofurantoin susceptibility. Six NIT-R E. coli (NRCI-1 to -6) isolated from stools of UTI patients treated with nitrofurantoin, cefuroxime, or a fluoroquinolone harbored mutations in nfsA and/or nfsB, but not in ribE. Sequencing of the ribE gene in six intestinal and three urinary E. coli strains showing reduced nitrofurantoin-susceptibility (MIC range 16-48 μg/ml) also did not identify any relevant mutations. NRCI-1, -2, -5 exhibited upto four-fold higher anaerobic MICs compared to the in vitro mutants, presumably because of additional mutations in oxygen-sensitive nitroreductases.
    Antimicrobial Agents and Chemotherapy 09/2014; · 4.57 Impact Factor
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    ABSTRACT: To perform the first multinational Enterobacter cloacae clonality study, using the MLST scheme newly developed in Japan.
    Journal of Antimicrobial Chemotherapy 09/2014; · 5.34 Impact Factor
  • Journal of Antimicrobial Chemotherapy 09/2014; · 5.34 Impact Factor
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    ABSTRACT: De novo genome assembly can be challenging due to inherent properties of the reads, even when using current state-of-the-art assembly tools based on de Bruijn graphs. Often users are not bio-informaticians and, in a black box approach, utilise assembly parameters such as contig length and N50 to generate whole genome sequences, potentially resulting in mis-assemblies.
    BMC Research Notes 07/2014; 7(1):484.
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    ABSTRACT: Rhinovirus infections occur frequently throughout life and have been reported in about one-third of asymptomatic cases. The clinical significance of sequential rhinovirus infections remains unclear. To determine the incidence and clinical relevance of sequential rhinovirus detections, nasopharyngeal samples from 2485 adults with acute cough/lower respiratory illness were analysed. Patients were enrolled prospectively by general practitioners from 12 European Union countries during three consecutive years (2007-2010). Nasopharyngeal samples were collected at the initial general practitioner consultation and 28 days thereafter and symptom scores were recorded by patients over that period. Rhinovirus RNA was detected in 444 (18%) out of 2485 visit one samples and in 110 (4.4%) out of 2485 visit two respiratory samples. 21 (5%) of the 444 patients had both samples positive for rhinovirus. Genotyping of both virus detections was successful for 17 (81%) out of 21 of these patients. Prolonged rhinovirus shedding occurred in six (35%) out of 21 and re-infection with a different rhinovirus in 11 (65%) out of 21. Rhinovirus re-infections were significantly associated with chronic obstructive pulmonary disease (p=0.04) and asthma (p=0.02) and appeared to be more severe than prolonged infections. Our findings indicate that in immunocompetent adults rhinovirus re-infections are more common than prolonged infections, and chronic airway comorbidities might predispose to more frequent rhinovirus re-infections.
    The European respiratory journal. 07/2014; 44(1):169-77.
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    ABSTRACT: Infection with human cytomegalovirus (CMV) is a significant cause of morbidity and mortality in solid organ and hematopoietic stem cell transplant (HSCT) recipients.
    Transplantation 07/2014; · 3.78 Impact Factor
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    ABSTRACT: While multiple rodent pre-clinical studies, and to a lesser extent human clinical trials, claim the feasibility, safety and potential clinical benefit of cell grafting in the central nervous system (CNS), currently only little convincing knowledge exists regarding the actual fate of the grafted cells and their effect on the surrounding environment (or vice versa). Our preceding studies already indicated that only a minor fraction of the initially grafted cell population survives the grafting process, while the surviving cell population becomes invaded by highly activated microglia/macrophages and surrounded by reactive astrogliosis. In the current study, we further elaborate on early cellular and inflammatory events following syngeneic grafting of eGFP(+) mouse embryonic fibroblasts (mEFs) in the CNS of immune-competent mice. Based on obtained quantitative histological data, we here propose a detailed mathematically-derived working model that sequentially comprises hypoxia-induced apoptosis of grafted mEFs, neutrophil invasion, neo-angiogenesis, microglia/macrophage recruitment, astrogliosis and eventually survival of a limited number of grafted mEFs. Simultaneously, we observed that the cellular events following mEF grafting activates the sub-ventricular zone neural stem and progenitor cell compartment. This proposed model therefore further contributes to our understanding of cell graft-induced cellular responses, and will eventually allow for successful manipulation of this intervention.
    Cell transplantation. 07/2014;
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    ABSTRACT: Canuti and Martin Deijs have contributed equally to this work. Previously unknown or unexpected pathogens may be responsible for that proportion of respiratory diseases in which a causative agent cannot be identified. The application of broad-spectrum, sequence independent virus discovery techniques may be useful to reduce this proportion and widen our knowledge about respiratory pathogens. Thanks to the availability of high-throughput sequencing (HTS) technology, it became today possible to detect viruses which are present at a very low load, but the clinical relevance of those viruses must be investigated. In this study we used VIDISCA-454, a restriction enzyme based virus discovery method that utilizes Roche 454 HTS system, on a nasal swab collected from a subject with respiratory complaints. A γ-papillomavirus was detected (complete genome: 7142 bp) and its role in disease was investigated. Respiratory samples collected both during the acute phase of the illness and 2 weeks after full recovery contained the virus. The patient presented antibodies directed against the virus but there was no difference between IgG levels in blood samples collected during the acute phase and 2 weeks after full recovery. We therefore concluded that the detected γ-papillomavirus is unlikely to be the causative agent of the respiratory complaints and its presence in the nose of the patient is not related to the disease. Although HTS based virus discovery techniques proved their great potential as a tool to clarify the etiology of some infectious diseases, the obtained information must be subjected to cautious interpretations. This study underlines the crucial importance of performing careful investigations on viruses identified when applying sensitive virus discovery techniques, since the mere identification of a virus and its presence in a clinical sample are not satisfactory proofs to establish a causative link with a disease.
    Frontiers in Microbiology 07/2014; 5:374. · 3.90 Impact Factor
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    ABSTRACT: The purposes of this study were to investigate the intestinal carriage of extended-spectrum β-lactamase-harbouring Enterobacteriaceae (ESBL-EN) and associated fluoroquinolone resistance (FQ-R) in 120 hospitalised patients with antibiotic-associated diarrhoea, and to investigate a correlation between Clostridium difficile (C. difficile) infection and intestinal colonisation with ESBL-EN in these patients. Stool samples were screened for C. difficile infection by toxin A/B enzyme-linked immunosorbent assay (ELISA) and for the presence of enterobacterial isolates producing β-lactamases by plating on β-lactamase screening (BLSE) agar. Recovered isolates were confirmed pheno- and genotypically for the presence of ESBL genes (bla CTX-M, bla TEM, bla SHV) by the double-disc synergy test and polymerase chain reaction (PCR) sequencing, and tested for the presence of topoisomerase mutations (gyrA, parC) and plasmid-mediated quinolone resistance (PMQR) determinants [qnrA, qnrB, qnrS, qepA, aac(6')-Ib-cr] by PCR sequencing. ESBL-EN were detected in 44/120 (37 %) stool samples. C. difficile-infected patients showed a significantly higher frequency of intestinal colonisation with ESBL-EN compared to C. difficile non-infected patients (62 % vs. 31 %, p = 0.008). Of the 73 ESBL-EN recovered, 46 (63 %) showed high-level FQ-R [ciprofloxacin minimum inhibitory concentration (MIC) ≥32 mg/L]. The largest group consisted of 21 bla CTX-M-15-harbouring Enterobacteriaceae (ciprofloxacin MIC ≥64 mg/L) with multiple topoisomerase mutations in gyrA and parC, in combination with co-carriage of aac(6')-Ib-cr. Most of them were Escherichia coli isolates belonging to sequence types ST131 and ST410. We found remarkably high rates of intestinal colonisation with high-level FQ-R ESBL-EN in hospitalised patients with antibiotic-associated diarrhoea, especially among C. difficile-infected patients. These data underscore the need for stringent infection control to contain this potentially infectious and multidrug-resistant reservoir.
    European Journal of Clinical Microbiology 07/2014; 33(12). · 3.02 Impact Factor
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    ABSTRACT: Although implantation of cellular material in the central nervous system (CNS) is a key direction in CNS regenerative medicine, this approach is currently limited by the occurrence of strong endogenous immune cell responses. In a model of mesenchymal stem cell (MSC) grafting in the CNS of immune-competent mice, we previously described that MSC grafts become highly surrounded and invaded by Iba1(+) myeloid cells (microglia and/or macrophages). Here, following grafting of blue fluorescent protein (BFP)-expressing MSC in the CNS of CX3CR1(+/-) and CX3CR1(-/-) mice, our results indicate: (1) that the observed inflammatory response is independent of the fractalkine signalling axis, and (2) that a significant spatial distribution of Iba1(+) inflammatory cells occurs, in which Iba1(+) CX3CR1(+) myeloid cells mainly surround the MSC graft and Iba1(+) CX3CR1(-) myeloid cells mainly invade the graft at 10 days post transplantation. Although Iba1(+) CX3CR1(+) myeloid cells are considered to be of resident microglial origin, Iba1(+) CX3CR1(-) myeloid cells are most likely of peripheral monocyte/macrophage origin. In order to confirm the latter, we performed MSC-BFP grafting experiments in the CNS of eGFP(+) bone marrow chimeric C57BL/6 mice. Analysis of MSC-BFP grafts in the CNS of these mice confirmed our observation that peripheral monocytes/macrophages invade the MSC graft and that resident microglia surround the MSC graft site. Furthermore, analysis of major histocompatibility complex class II (MHCII) expression revealed that mainly macrophages, but not microglia, express this M1 pro-inflammatory marker in the context of MSC grafting in the CNS. These results again highlight the complexity of cell implantation immunology in the CNS.Immunology and Cell Biology advance online publication, 1 July 2014; doi:10.1038/icb.2014.49.
    Immunology and Cell Biology 07/2014; · 3.93 Impact Factor
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    ABSTRACT: Cervarix™ is approved as a preventive vaccine against infection with the human papillomavirus (HPV) strains 16 and 18, which are causally related to the development of cervical cancer. We are the first to investigate in vitro the effects of this HPV vaccine on interleukin (IL)-15 dendritic cells (DC) as proxy of a naturally occurring subset of blood DC, and natural killer (NK) cells, two innate immune cell types that play an important role in antitumour immunity. Our results show that exposure of IL-15 DC to the HPV vaccine results in increased expression of phenotypic maturation markers, pro-inflammatory cytokine production and cytotoxic activity against HPV-positive tumour cells. These effects are mediated by the vaccine adjuvant, partly through Toll-like receptor 4 activation. Next, we demonstrate that vaccine-exposed IL-15 DC in turn induce phenotypic activation of NK cells, resulting in a synergistic cytotoxic action against HPV-infected tumour cells. Our study thus identifies a novel mode of action of the HPV vaccine in boosting innate immunity, including killing of HPV-infected cells by DC and NK cells.
    Journal of Cellular and Molecular Medicine 06/2014; · 4.75 Impact Factor
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    ABSTRACT: Background / Purpose: To study the effects of a human papillomavirus (HPV) vaccine on a natural existing dendritic cell (DC) subset and the subsequent effects on natural killer (NK) cell activity. Main conclusion: The HPV vaccine is able to maturate the interleukin 15 (IL-15) dendritic cells. In addition, the vaccine is capable of unlocking the cytotoxic capacity of these IL-15 dendritic cells and increases the dendritic cell-mediated NK cell cytotoxicity.
    12th Cancer Immunotherapy (CIMT) Annual Meeting 2014; 05/2014
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    ABSTRACT: Infections remain a leading cause of morbidity and mortality in patients with reduced immunity caused by haematological disease and chemotherapy-induced neutropenia. We evaluated the clinical and microbiological impact of discontinuing fluoroquinolone prophylaxis in these patients. We analysed 154 admissions in three sequential periods of 8 months: long-standing use, discontinuation and reintroduction of prophylaxis. Clinical endpoints were occurrence of febrile neutropenia, bacteraemia, severe sepsis, septic shock, response to antibiotic therapy, total antibiotic consumption and duration of hospital stay. Microbiological analysis included bacterial isolates from stool and blood cultures and their resistance pattern. No significant increase in serious infectious complications was seen with the discontinuation of prophylaxis. The overall incidence of bacteraemia did not change, but a higher proportion of bacterial isolates were Gram-negative (22.2% versus 5.9% & 8.6%; p=0.030), more often multi-susceptible (50% versus 0%) and less fluoroquinolone-resistant (10% versus 100%). Screening of stools showed a higher prevalence of organisms in the discontinuation period (86.7% versus 37.3% & 55.2%; p=<0.001), but they were more frequently multi-susceptible (53.8% versus 10.5% & 6.3%; p=<0.001). After discontinuation of prophylaxis, fluoroquinolone resistance decreased rapidly from 73.7% to 7.7%, in association with a significant decrease in extended spectrum beta-lactamase (ESBL)-producing isolates from 42.1% to 10.3%. Resistance figures immediately returned to pre-discontinuation values after reinstitution of prophylaxis. No clinically relevant short-term drawbacks were observed with the discontinuation of fluoroquinolone prophylaxis in patients with chemotherapy-induced prolonged profound neutropenia, which led to a significant decrease in fluoroquinolone resistance as well as occurrence of ESBL-producing isolates. This article is protected by copyright. All rights reserved.
    European Journal Of Haematology 04/2014; · 2.55 Impact Factor

Publication Stats

10k Citations
2,602.68 Total Impact Points

Institutions

  • 2014
    • University of Nottingham
      • Division of Primary Care
      Nottigham, England, United Kingdom
  • 1993–2014
    • University of Antwerp
      • Vaccine & infectious disease institute
      Antwerpen, Flanders, Belgium
    • Universitair Ziekenhuis Ghent
      Gand, Flanders, Belgium
  • 2013
    • Universiteit Hasselt
      • Biomedical Research Institute (BIOMED)
      Diepenbeek, VLG, Belgium
    • University Medical Center Utrecht
      • Julius Center for Health Sciences and Primary Care
      Utrecht, Utrecht, Netherlands
  • 2011–2013
    • University of Amsterdam
      • • Department of Medical Microbiology
      • • Faculty of Medicine AMC
      Amsterdamo, North Holland, Netherlands
    • København Zoo
      København, Capital Region, Denmark
    • University of Lodz
      Łódź, Łódź Voivodeship, Poland
  • 2012
    • Polytech Paris-UPMC
      Lutetia Parisorum, Île-de-France, France
    • University of Southampton
      • Academic Unit of Primary Care and Population Science
      Southampton, England, United Kingdom
  • 2009–2012
    • Cardiff University
      • • South East Wales Trials Unit
      • • Department of Primary Care and Public Health
      Cardiff, WLS, United Kingdom
    • European Centre for Disease Prevention and Control
      Solna, Stockholm, Sweden
  • 2008–2012
    • Mater Dei Hospital
      La Valette, Il-Belt Valletta, Malta
    • French Institute of Health and Medical Research
      Lutetia Parisorum, Île-de-France, France
  • 2007–2011
    • Erasmushogeschool Brussel
      Bruxelles, Brussels Capital Region, Belgium
    • Robert Koch Institut
      Berlín, Berlin, Germany
    • Instituto de Salud Carlos III
      Madrid, Madrid, Spain
  • 1992–2011
    • Ghent University
      • • Laboratory of Microbiology
      • • Department of Pathology, Bacteriology and Avian Diseases
      • • Faculty of Veterinary Medicine
      Gent, VLG, Belgium
    • Hôpital Universitaire des Enfants Reine Fabiola
      • Department of Gastroenterology
      Bruxelles, Brussels Capital Region, Belgium
    • University-Hospital Brugmann UVC
      Bruxelles, Brussels Capital Region, Belgium
  • 2010
    • University of Dundee
      Dundee, Scotland, United Kingdom
    • University of Bordeaux
      Burdeos, Aquitaine, France
    • University of Bergamo
      Bérgamo, Lombardy, Italy
  • 1999–2007
    • Université Libre de Bruxelles
      • Laboratory of Microbiology
      Brussels, BRU, Belgium
    • University Hospital Linköping
      • Department of Infectious Diseases
      Linköping, Östergötland, Sweden
  • 2006
    • University of Aberdeen
      Aberdeen, Scotland, United Kingdom
    • Belgian Scientific Institute for Public Health
      Bruxelles, Brussels Capital Region, Belgium
  • 2003–2006
    • Leiden University Medical Centre
      • Department of Medical Microbiology
      Leyden, South Holland, Netherlands
  • 2005
    • Statens Serum Institut
      København, Capital Region, Denmark
  • 2004
    • Hacettepe University
      • Department of Internal Medicine
      Ankara, Ankara, Turkey
  • 2001–2003
    • Universitair Ziekenhuis Antwerpen
      Antwerpen, Flanders, Belgium
  • 2002
    • National Cheng Kung University Hospital
      臺南市, Taiwan, Taiwan
  • 2000
    • Pierre and Marie Curie University - Paris 6
      Lutetia Parisorum, Île-de-France, France
  • 1995
    • AZ Sint-Jan Brugge-Oostende
      Bruges, Flanders, Belgium
  • 1992–1993
    • University of Leicester
      • Department of Genetics
      Leicester, ENG, United Kingdom
  • 1985–1993
    • University Hospital Brussels
      Bruxelles, Brussels Capital Region, Belgium
    • University of Geneva
      Genève, Geneva, Switzerland
  • 1991
    • University of Cologne
      • Institute for Medical Microbiology, Immunology and Hygiene
      Köln, North Rhine-Westphalia, Germany
  • 1983–1988
    • Centre Hospitalier Universitaire Saint-Pierre
      Bruxelles, Brussels Capital Region, Belgium
  • 1985–1986
    • Vrije Universiteit Brussel
      • Department of Microbiology
      Bruxelles, Brussels Capital Region, Belgium