Erlangga Yusuf

Universitair Ziekenhuis Antwerpen | UZA · Department of Clinical Biology

This study investigated the frequency of change of the antimicrobial susceptibility pattern when the same isolate was found in the same patient in various situations. We used laboratory data collected over a period of 8 years (January 2014 to December 2021) at the clinical microbiology laboratory of a tertiary hospital for Escherichia coli, Klebsie...

The aim of this paper is to describe the prevalence of Mycoplasma genitalium and Trichomonas vaginalis in patients who visited general practitioners in the Netherlands. Additionally, we describe the prevalence of M. genitalium resistance to azithromycin and moxifloxacin. We used data from 7,411 consecutive female patients who were screened for Chla...

The interpretation of 'susceptible (S)' or 'resistant (R)' results of antimicrobial susceptibility testing is easily understood, but the interpretation of the 'intermediate (I)' category can be confusing. This review critically discusses how this categorization (clinical breakpoints) comes into being with the emphasis on the use of pharmacokinetics...

The performance of a test can be suboptimal, but in appropriate setting such a test is still useful for clinical decision making. We investigated the role of Antigen Rapid Diagnostic Test (Ag-RDT) for clinical decision making in an Emergency Department (ED) in Curacao during peak of COVID-19 pandemic. Ag-RDT was performed in the naso- and oropharyn...

Infection in critically ill patients is an important problem [...].

Background This study aims to give an overview on how microbiology diagnosis tests of Prosthetic joint infections (PJI) is performed in Europe, and to explore whether any factor influences the decision on implementing a test. Methods An extensive online survey of clinical microbiologists from seven European countries (Belgium, Estonia, Germany, It...

Background: Acinetobacter baumannii can cause difficult-to-treat infections because it can acquire extensive antimicrobial resistance mechanisms. We aim to describe the antimicrobial resistance pattern and the genetic basis of carbapenem-nonsusceptible A. baumannii isolates in a University Hospital in Romania, a country where multidrug-resistant A....

Background Climate change poses a significant threat to humanity and human activity is largely responsible for it. Clinical microbiology laboratories have their unintended shares in CO2 emission. The aim of this study is to estimate CO2 emission of a clinical microbiology laboratory, and to propose initiatives to reduce the emissions. Methods CO2...

Fosfomycin is increasingly needed to treat infection due to multidrug resistant microorganisms. Yet, the antimicrobial susceptibility test (AST) of fosfomycin is fraught with difficulties or often laborious to perform. An easy-to-use AST method for fosfomycin is thus needed. In this study, we showed that the ready-to-use commercially available agar...

Background Tissues are valuable specimens in diagnostic microbiology because they are often obtained by invasive methods, and effort should thus be taken to maximize microbiological yield. The objective of this study was to evaluate the added value of using tissue pre-processing (tissue homogenizer instrument gentleMACS Dissociator) in detecting mi...

Several reports have been published on Aspergillus findings in COVID-19 patients leading to a proposition of new disease entity COVID-19-associated pulmonary aspergillosis. This scoping review is designed at clarifying the concepts on how the findings of Aspergillus spp. in COVID-19 patients were interpreted. We searched Medline to identify the stu...

Serology assay has a long history. This paper accompanies four narrative reviews on the practical application of serology assay in clinical and public health practice, such as the use of avidity index, serology tests for fungal infections, serology test for emerging infectious disease, and the pooling strategy.

Infective endocarditis, osteomyelitis, and osteosynthesis-associated infections are mostly caused by Gram-positive bacteria. They are often difficult to treat and are associated with a poor prognosis. In the past 20 years, nine antibiotic drugs with predominant activity against Gram-positive bacteria have been introduced and approved by the Food an...

Background Serological techniques are an essential part of the diagnostic tools used in clinical virology. Among these techniques, antibody indexes are not novel, but do require specific expertise. Their niche has expanded substantially in recent years due to increasing evidence of their performance to diagnose viral infections. Objectives This na...

Infections in the ICU are often caused by Gram-negative bacteria. When these microorganisms are resistant to third-generation cephalosporines (due to extended-spectrum (ESBL) or AmpC beta-lactamases) or to carbapenems (for example carbapenem producing Enterobacteriales (CPE)), the treatment options become limited. In the last six years, fortunately...

Background Coagulase-negative staphylococci (CoNS) are part of the normal skin flora. Although CoNS are generally considered as low pathogenic microorganisms, they can cause serious infections, particularly in the context of foreign body material. Case report Here we present two cases of concomitant infectious endocarditis and spondylodiscitis; on...

p align="left">According to the World Health Organization (WHO), primary health care (PHC) can be defined as a whole-of-society approach to health and well-being, centered on the needs and preferences of individuals, families and communities. In the last five years, several major events occurred that emphasize the importance of and the need for PHC...

The aim of this study was to describe the frequency of positive Aspergillus tests in COVID-19 patients and investigate the association between COVID-19 and a positive Aspergillus test result. We compared the proportion of positive Aspergillus tests in COVID-19 patients admitted to the ICU for > 24 hours with two control groups; patients with commun...

Colistin is considered as one of the last-resort antibiotics and reliable antimicrobial susceptibility testing is therefore crucial. The reference standard for AST according to EUCAST and CLSI is broth microdilution (BMD). However, BMD is labor intensive to perform. Commercial antimicrobial susceptibility tests derived from BMD method are available...

The world is experiencing a severe COVID-19 outbreak. To control this outbreak, many governments in the world have imposed lockdown or quarantine measures. We hypothesize that these measures may cause additional mortality and morbidity in the (near) future due to delay in diagnosing diseases and other indirect effect on health (such as economic cri...

Klebsiella pneumoniae carbapenemase-producing Klebsiella pneumoniae (KPC-KP) is a difficult-to-treat pathogen due to its multidrug-resistant phenotype. Cardiac surgery patients are at increased risk of developing KPC-KP infections compared to other populations, with previous KPC-KP colonization being a critical factor in influencing the risk of sub...

Surgical prophylaxis is given to prevent surgical site infection and prosthetic joint infection (PJI) in prosthetic joint surgery. The common pathogens for delayed PJI are often resistant to common surgical prophylaxis antibiotics, with large clinical and economic consequences. We discuss the possible use of vancomycin (to which the most common cau...

Objectives: We evaluated the treatment outcome in late acute (LA) periprosthetic joint infections (PJI) treated with debridement and implant retention (DAIR) versus implant removal. Methods: In a large multicenter study, LA PJIs of the hip and knee were retrospectively evaluated. Failure was defined as: PJI related death, prosthesis removal or t...

Objectives: Debridement, antibiotics and implant retention (DAIR) is the recommended treatment for all acute prosthetic joint infections (PJI), but its efficacy in patients with late acute (LA) PJI is not well described. Methods: Patients diagnosed with LA PJI between 2005 and 2015 were retrospectively evaluated. LA PJI was defined as the develo...

In May 2018, the World Health Organisation (WHO) released the Model List of Essential In Vitro Diagnostics (EDL). In this Commentary we review the EDL components that are relevant to clinical microbiology, particularly antimicrobial stewardship, and formulate some discussion points for future versions of the EDL.

Deep sternal wound infection (DSWI), also known as mediastinitis, is a serious and potentially fatal condition. The diagnosis and treatment of DSWI are challenging. In this current narrative review, the epidemiology, risk factors, diagnosis, and surgical and antimicrobial management of DSWI are discussed. Ideally, the management of DSWI requires ea...

Background: Antibiotics are frequently used in intensive care units (ICUs), and their use is associated with the emergence of bacterial resistance to antibiotics. The aim of this study was to investigate the association between the emergence of Pseudomonas aeruginosa resistance and the duration of antibiotic exposure or mode of administration in a...

Objectives: To compare the quality of antibacterial with antifungal prescribing in the world. Methods: Data from the global point prevalence study (Global PPS) were used. The Global PPS took place on any one day between February and June 2015 in 335 participating hospitals from 53 countries. It collected demographic data on patients treated with...

The purpose of this investigation was to assess the balance between the personal and professional lives of trainees and young European specialists in clinical microbiology (CM) and infectious diseases (ID), and determine differences according to gender, country of training, workplace and specialty. The Steering Committee of the Trainee Association...

The incidence of whooping cough, a contagious respiratory disease caused by Bordetella pertussis, is on the rise despite existing vaccination programmes. Similar, though usually milder, respiratory symptoms may be caused by other members of the Bordetella genus: B. parapertussis, B. holmesii, and B. bronchiseptica. Pertussis diagnosis is mostly don...

Results used to determine accuracy, specificity, analytical sensitivity and precision. (XLSX)

Clinical results from January 2013 until December 2015. (XLSX)

The purpose of this investigation was to perform a survey among European clinical microbiology (CM) and infectious disease (ID) trainees on training satisfaction, training tools, and competency assessment. An online, anonymous survey in the English language was carried out between April and July 2015. There were 25 questions: seven in a 5-point Lik...

Objective: To investigate the effect of a quality improvement project that resulted in an infection control bundle to reduce the number of spinal cord stimulator (SCS) infections. Materials and methods: The study was performed in a single center for neuromodulation from January 1, 2014, through May 31, 2016. In response to a high number of surgi...

Aims: Results of urinalysis are available earlier than urine culture results. If urinalysis can predict results of culture, early decision can be made on treatment and whether urine samples should be cultured. This study sought to compare the performance of urinalysis tests by automated test strip analyser (nitrite and leucocyte esterase) with flo...

The increasing prevalence of carbapenemase-producing Enterobacteriaceae necessitates laboratories to invest in the detection of these bacteria, both with phenotypic and to a lesser extent molecular methods. OXA-48-like strains are rapidly emerging, especially in Europe. Since the expression level of OXA-48 is low and some strains present with sever...

Osteoarthritis (OA) is not merely a degenerative disease but a disease of the whole joint. The aims of OA treatment are to alleviate pain and to improve function. The effect of pharmacologic and non-pharmacologic treatment in OA as shown by randomized control trials (RCTs) is often small or moderate. The treatment should be therefore personalized s...

Objective: To investigate the course of synovitis on contrast-enhanced MRI in osteoarthritic knees over 2 years, and its association with pain and cartilage deterioration. Design: Consecutive patients (n=39, mean age 61 years, 79% woman, median (range) BMI 29 (24-48) kg/mm(2)) with clinical OA were included. Baseline and follow-up contrast-enhan...

Objective: To get a better understanding of inflammatory pathways active in the osteoarthritic (OA) joint, we characterized and compared inflammatory cells in the synovium and the infrapatellar fat pad (IFP) of patients with knee OA. Methods: Infiltrating immune cells were characterized by flow cytometry in 76 patients with knee OA (mean age 63....

Background While most cases of polymicrobial vertebral osteomyelitis are secondary to hematogenous seeding, direct inoculation during spinal surgery and contiguous spread from adjacent soft tissue are also potential routes whereby pathogens may infect the spine. Case presentation A 74 year-old man presented with an exacerbation of back pain after...

Fusobacterium nucleatum is anaerobic oral microbiota that might be associated with cancer. We reported 22 consecutive cases of patients (mean age of 63.8 years (range 34 to 89), 59.1% male) with F. nucleatum bacteremia that were admitted to a university hospital over a 10-year period. In 17 (77.2%) of these patients, F. nucleatum was the sole possi...

Objective: To investigate the presence of mast cells in the osteoarthritic (OA) synovium and their association with clinical parameters in comparison with rheumatoid arthritis (RA) samples. Method: Synovial tissues of 56 symptomatic OA and 49 RA patients were obtained. Two to three paraffin slides were used to quantify inflammation using haemato...

Objective: To investigate patterns of MRI abnormalities in the patellofemoral (PFJ) and tibiofemoral joint (TFJ) and their association with radiographic progression, using hypothesis free analyses. Design: 205 patients from the GARP study with symptomatic OA at multiple sites (mean age 60 years, 80% woman, median BMI 26 kg/m(2)), underwent knee...

We reported a woman with urinary-tract infection caused by OXA-48 producing Klebsiella pneumoniae. Using molecular techniques, we showed that she might acquire this bacterium from another family member who lived in the same house. The two isolates, although different by pulsed-field gel electrophoresis and multilocus sequence typing, carried blaOXA...

To describe the epidemiology, the surgical treatment, the microbiology, the antibiotic prophylaxis and the outcome of patients with the most severe type of open fractures. Retrospective chart reviews of patients with Gustilo type III open fracture admitted to an university hospital in Switzerland between January 2007 and December 2011. The patient'...

Fusobacterium spp. from clinical specimens are increasingly reported. We sought to describe the epidemiology, the microbiological, and the clinical characteristics of head and neck infections caused by F. necrophorum and other Fusobacterium spp. Retrospective cohort study between October 1(st), 2004 and September 30(th), 2014 performed in an academ...

The number of total knee replacement (TKR) infections is expected to increase along with the growing number of TKR implanted. The ultimate aim in treating TKR infections is to regain a pain free and functional joint. Whenever possible, the joint should also be free of infection. In order to achieve these goals, a clear treatment concept is needed....

Objective: To determine patterns of synovitis on contrast-enhanced magnetic resonance images and its relation to pain and severity of radiographic OA. Methods: 86 patients (mean age 62 years, 66% woman, median BMI 29 kg/mm(2) and Kellgren-Lawrence score 3 ) with symptomatic knee OA were included. T1-weighted Gd-chelate-enhanced MRI with fat-suppres...

Background: Daptomycin is used increasingly to treat prosthetic joint infection (PJI). A possible side effect of this drug is eosinophilic pneumonia. We describe two patients with PJI treated with daptomycin who had this side effect with different clinical presentations. Methods: Case reports and review of the literature. Results: The first ca...

Current diagnostic methods in differentiating septic from non-septic arthritis are time-consuming (culture) or have limited sensitivity (Gram stain). Microcalorimetry is a novel method that can rapidly detect microorganisms by their heat production. We investigated the accuracy and time to detection of septic arthritis by using microcalorimetry. Pa...

Septic arthritis of the pubic symphisis is distinguished from osteitis pubis by positive cultures. The symptoms, physical examination and laboratory findings of these two conditions are comparable. We present a case of 57-year-old woman with septic arthritis of pubic symphisis caused by Streptococcus mitis, a commensal oral flora that belongs to vi...

Purpose: The purpose of this study is to review the rationale of prolonged (ie, extended or continuous) infusion of piperacillin/tazobactam (PIP/TAZ) in critically ill patients and to perform a systematic review that compare the effectiveness of prolonged infusion with intermittent bolus of PIP/TAZ. Materials and methods: A search of Medline, We...

Objectives: To describe the use of sonication and microcalorimetry in diagnosing necrotizing fasciitis in a 27-year-old woman with bilateral breast implants. Methods: The removed breast implants were subjected to sonication and microcalorimetry. The microcalorimetry findings were correlated with conventional microbiologic methods. The time to de...

The purpose of this investigation was to compare the performance and cost of the Carba NP test with the Rapid CARB Screen Kit in detecting the presence of carbapenemase in Enterobacteriaceae and Pseudomonas aeruginosa. Ninety-two Enterobacteriaceae and 19 P. aeruginosa strains were used in this study. Multiplex polymerase chain reaction (PCR) was p...

Background Mast cells could be important in osteoarthritis (OA), as it is the only type of immune cell whose numbers were shown to be as high or sometimes higher compared to rheumatoid arthritis (RA). To assess their role in OA, we investigated whether the number and activation status of mast cells varies with the disease stage in OA. Objectives To...

Clindamycin is a possible treatment of infections caused by Gram-positive cocci. However, its use can be limited by inducible clindamycin resistance. To screen for the presence of this type of resistance, D-zone test is used. The aim of this study is to compare the performance of SirScan®paper disks with Rosco Neo-sensitabs™ for D-zone test at dist...

We evaluated the performance of the ChromID MRSA/ChromID S. aureus biplate for the simultaneous detection of Staphylococcus aureus and methicillin-resistant S. aureus (MRSA) in preoperative screening samples. The sensitivity and specificity were 94.2% and 93.6%, respectively, for the S. aureus compartment and 92.9% and 99.7% for the MRSA compartmen...

Background: Pyoderma gangrenosum is an ulcerative, non-infectious skin disorder. However, it can be mistaken as necrotizing fasciitis, a life-threatening infective condition. We describe here a case of pyoderma gangrenosum after minor trauma treated as necrotizing fasciitis. Methods: Case report and literature review. Case report: A 27-year-ol...

To evaluate the association between synovitis on contrast enhanced (CE) MRI with microscopic and macroscopic features of synovial tissue inflammation. Forty-one patients (mean age 60 years, 61% women) with symptomatic radiographic knee OA were studied: twenty underwent arthroscopy (macroscopic features were scored (0-4), synovial biopsies obtained)...

No earlier study has investigated the microbiology of negative pressure wound therapy (NPWT) foam using a standardized manner. The purpose of this study is to investigate the bacterial load and microbiological dynamics in NPWT foam removed from chronic wounds (>3 months). To determine the bacterial load, a standardized size of the removed NPWT foam...

Proper and rapid diagnosis of orthopedic device-related infection is important for successful treatment. Sonication has been shown to improve the diagnostic performance. We hypothesized that the combination of sonication with a novel method called microcalorimetry will further improve and accelerate the diagnosis of implant infection. We prospectiv...